Predictors in the Treatment of Difficult-to-control Seizures by Electrical Stimulation of the Centromedian Thalamic Nucleus

Velasco, Francisco; Velasco, Marcos; Jiménez, Fiacro; Velasco, Ana Luisa; Brito, Francisco; Rise, Mark T.; Carrillo-Ruíz, José Damián

doi:10.1097/00006123-200008000-00007

Cited by 174 publications

(138 citation statements)

References 26 publications

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“…Velasco et al reported their first 5 cases of CMT DBS in 1987 [98], and larger series in 2000 [99] and 2006 [100], using an alternating left-right stimulation paradigm (60 Hz, 500-600 μA, 1 min on/4 min off, 24 h/day). Seizure frequency was measured during a 1-month baseline period and monthly for 18 months postoperatively during open-label stimulation.…”

Section: Centromedian Nucleus Of the Thalamusmentioning

confidence: 99%

Deep Brain Stimulation for the Treatment of Epilepsy: Circuits, Targets, and Trials

2014

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Deep brain stimulation (DBS) has proven remarkably safe and effective in the treatment of movement disorders. As a result, it is being increasingly applied to a range of neurologic and psychiatric disorders, including medically refractory epilepsy. This review will examine the use of DBS in epilepsy, including known targets, mechanisms of neuromodulation and seizure control, published clinical evidence, and novel technologies. Cortical and deep neuromodulation for epilepsy has a long experimental history, but only recently have better understanding of epileptogenic networks, precise stereotactic techniques, and rigorous trial design combined to improve the quality of available evidence and make DBS a viable treatment option. Nonetheless, underlying mechanisms, anatomical targets, and stimulation parameters remain areas of active investigation.

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Section: Centromedian Nucleus Of the Thalamusmentioning

confidence: 99%

Deep Brain Stimulation for the Treatment of Epilepsy: Circuits, Targets, and Trials

2014

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“…The main DBS targets investigated for the treatment of epilepsy are the centromedian nucleus of the thalamus, 137 120 and mammillary bodies. 23 Candidates for the procedure often have frequent disabling seizures, a significant impairment in quality of life, refractoriness to treatment with multiple antiepileptic medications, and either bilateral/multifoci seizures or a nonidentifiable seizure focus.…”

Section: Epilepsymentioning

confidence: 99%

“…Overall, centromedian nucleus DBS has been suggested to be more effective against generalized tonic-clonic seizures, atypical absence seizures, and Lennox-Gastaut syndrome. 134,137,140 Anterior thalamic nuclei and hippocampal DBS have been primarily used for the treatment of partial epilepsies. 6,13,46,53,67,75,95,128,135,136,146 In general, results of nonblinded studies in various targets have been very promising, but sometimes not corroborated by blinded trials comparing the frequency of seizures in "on" and "off" stimulation conditions.…”

Section: Epilepsymentioning

confidence: 99%

Deep brain stimulation: current and future perspectives

Awan¹,

Lozano²,

Hamani³

2009

FOC

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Deep brain stimulation (DBS) has been used to treat various neurological and psychiatric disorders. Over the years, the most suitable surgical candidates and targets for some of these conditions have been characterized and the benefits of DBS well demonstrated in double-blinded randomized trials. This review will discuss some of the areas of current investigation and potential new applications of DBS.

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“…A recent mapping study suggested that this discrepancy of results may be attributable, at least in part, to differing stimulation loci within the CM. Selective stimulation of the ventral lateral part of the CM could recruit and desynchronize the direct current shift response, and this response was directly correlated with desired antiepileptic effects (Velasco et al, 2000). In addition to stimulating potential pathways of epileptic network, recent reports showed that DBS directly targeting the seizure focus had beneficial effects on intractable temporal lobe seizures (Vonck et al, 2002).…”

Section: Brain Stimulation For Neurological Disordersmentioning

confidence: 99%

Brain Stimulation for Neurological and Psychiatric Disorders, Current Status and Future Direction

Chang¹

2004

J Pharmacol Exp Ther

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Interest in brain stimulation therapies has been rejuvenated over the last decade and brain stimulation therapy has become an alternative treatment for many neurological and psychiatric disorders, including Parkinson's disease (PD), dystonia, pain, epilepsy, depression, and schizophrenia. The effects of brain stimulation on PD are well described, and this treatment has been widely used for such conditions worldwide. Treatments for other conditions are still in experimental stages and large-scale, well controlled studies are needed to refine the treatment procedures. In the treatment of intractable brain disorders, brain stimulation, especially transcranial magnetic stimulation (TMS), is an attractive alternative to surgical lesioning as it is relatively safe, reversible, and flexible. Brain stimulation, delivered either via deeply implanted electrodes or from a surface-mounted transcranial magnetic device, can alter abnormal neural circuits underlying brain disorders. The neural mechanisms mediating the beneficial effects of brain stimulation, however, are poorly understood. Conflicting theories and experimental data have been presented. It seems that the action of stimulation on brain circuitry is not limited to simple excitation or inhibition. Alterations of neural firing patterns and long-term effects on neurotransmitter and receptor systems may also play important roles in the therapeutic effects of brain stimulation. Future research on both the basic and clinical fronts will deepen our understanding of how brain stimulation works. Realtime computation of neural activity allows for integration of brain stimulation signals into ongoing neural processing. In this way abnormal circuit activity can be adjusted by optimal therapeutic brain stimulation paradigms.The modern era of brain stimulation treatment started in the 1950s with an early application of deep brain stimulation (DBS) to treat patients with intractable pain. Interest in DBS as a treatment for movement disorders has surged since the late 1980s. With the development of new devices such as transcranial magnetic stimulators and refinements in DBS paradigms, brain stimulation has been gradually replacing surgical ablation as a uniquely promising clinical procedure for the treatment of many neurological disorders that are unresponsive to existing therapies. Movement DisordersParkinson's Disease. Although pharmacological dopamine (DA) enhancement has therapeutic benefits for PD, long-term use also produces the undesirable side effect of dyskinesia. Surgical ablation and DBS were explored during the 1970s and 1980s. Benabid et al. (1987) reported that high-frequency stimulation of the ventral intermediate thalamic nucleus can suppress the tremor syndrome of PD. During the following decade, we witnessed tremendous interest and great success of DBS treatments in PD.Currently, the major targets of DBS for PD treatment are the subthalamic nucleus (STN) and the internal segment of globus pallidus (GPi) within the thalamocortical basal ganglia pathways....

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Predictors in the Treatment of Difficult-to-control Seizures by Electrical Stimulation of the Centromedian Thalamic Nucleus

Abstract: ESCM is an efficient and safe procedure for controlling certain seizure types, if patient selection and stereotactic placement are satisfactory.

Cited by 174 publications

References 26 publications

Deep Brain Stimulation for the Treatment of Epilepsy: Circuits, Targets, and Trials

Deep Brain Stimulation for the Treatment of Epilepsy: Circuits, Targets, and Trials

Deep brain stimulation: current and future perspectives

Brain Stimulation for Neurological and Psychiatric Disorders, Current Status and Future Direction

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