Subacute and Chronic Electrical Stimulation of the Hippocampus on Intractable Temporal Lobe Seizures

Velasco, Ana Luisa; Velasco, Marcos; Velasco, Francisco; Menes, Diana; Gordon, F; Rocha, Luísa; Briones, Magdalena; Márquez, Irma

doi:10.1016/s0188-4409(00)00064-3

Cited by 162 publications

(105 citation statements)

References 17 publications

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“…10) The present study demonstrated that low frequency stimulation had inhibitory effects in the limbic system, whereas high frequency stimulation was effective in the MD. Subacute and chronic electrical stimulation of the hippocampus at 130 Hz is effective for the treatment of temporal lobe epilepsy in humans, 23) whereas low frequency (1 Hz) stimulation of the epileptic focus has inhibitory effects on amygdala kindling in rats. 26,27) Therefore, the effects of varying stimulation parameters for DBS remain controversial.…”

Section: Discussionmentioning

confidence: 99%

Epileptic Focus Stimulation and Seizure Control in the Rat Model of Kainic Acid-Induced Limbic Seizures

Urino

Hashizume

Maehara

et al. 2010

Neurol. Med. Chir.(Tokyo)

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The inhibitory effects of deep brain stimulation (DBS) were investigated in a rat model of kainic acid (KA)-induced limbic status epilepticus. Wistar rats were injected with 1.0 mg KA into the left amygdala after stereotactic implantation of a guide cannula and electrodes. Bipolar rectangular pulses of 0.1 msec duration and 0.1-0.3 mA amplitude were applied intermittently to the left amygdala (10 Hz or 130 Hz), left ventral hippocampus (10 Hz), and left dorsomedial thalamus (130 Hz). Seizure frequency was evaluated by video electroencephalography monitoring and compared to control animals that did not receive DBS. All rats developed limbic status epilepticus 60-90 minutes after KA injection. Seizure frequency was significantly reduced by 10 Hz stimulation of the amygdala and by 130 Hz stimulation of the dorsomedial thalamus. No significant effects were observed with other types of stimulation. Seizure behaviors or duration of seizure were not changed significantly by DBS treatment. DBS of an epileptic focus may attenuate KA-induced limbic seizures, depending on the stimulation sites and parameters.

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Section: Discussionmentioning

confidence: 99%

Epileptic Focus Stimulation and Seizure Control in the Rat Model of Kainic Acid-Induced Limbic Seizures

Urino

Hashizume

Maehara

et al. 2010

Neurol. Med. Chir.(Tokyo)

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“…26,27,73 Subacute hippocampal stimulation (HS) using bilateral depth electrodes or unilateral electrode grids abolished complex partial and secondarily generalized tonic-clonic seizures and significantly decreased the number of interictal EEG spikes at the focus in 7 of 10 patients with intractable temporal lobe seizures. 74 A subsequent study of chronic HS by the same group in three patients demonstrated persistently blocked epileptogenesis with no negative effect on shortterm memory. 75 Continuous high-frequency HS for about 2 weeks in 10 patients revealed a significant decrease in seizures and interictal paroxysmal activity.…”

Section: Hippocampusmentioning

confidence: 90%

Deep Brain Stimulation for Epilepsy

et al. 2008

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Summary:Many patients who suffer from medically refractory epilepsy are not candidates for resective brain surgery. Success of deep brain stimulation (DBS) in relieving a significant number of symptoms of various movement disorders paved the way for investigations into this modality for epilepsy. Open-label and small blinded trials have provided promising evidence for the use of DBS in refractory seizures, and the first randomized control trial of DBS of the anterior thalamic nucleus is currently underway.There are multiple potential targets, because many neural regions have been implicated in seizure propagation. Thus, it is difficult as yet to make any definitive judgments about the efficacy of DBS for seizure control. Future study is necessary to identify a patient population for whom this technique would be indicated, the most efficacious target, and optimal stimulation parameters.

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“…Several studies of hippocampal slices and rodent models provided preclinical support for hippocampal DBS [22,36,58,59]. The first systematic human studies of hippocampal stimulation came from Velasco and colleagues, initially in a pilot study of stimulation prior to temporal lobectomy in 10 patients [27]. More recently, the same group reported 18-month follow-up of 9 patients with MTLE, 4 with classic radiological signs of hippocampal sclerosis (HS), and 5 with normal magnetic resonance (MR) images, who experienced 15-70 seizures per month (average of 28 seizures) [60].…”

Section: Hippocampal Formationmentioning

confidence: 99%

“…The ANT projects to the cingulate gyrus, then to the parahippocampal gyrus, followed by the entorhinal cortex, which finally projects via the perforant pathway back to the hippocampus [19,20]. Supporting the notion that neural networks provide multiple points for potential therapeutic interactions, lesions and high-frequency electrical stimulation at several locations along this pathway-including the hippocampus, mammillary bodies, subiculum, and ANT-have demonstrated effective modulation of seizure propagation [22][23][24][25][26][27].…”

mentioning

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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Subacute and Chronic Electrical Stimulation of the Hippocampus on Intractable Temporal Lobe Seizures

Cited by 162 publications

References 17 publications

Epileptic Focus Stimulation and Seizure Control in the Rat Model of Kainic Acid-Induced Limbic Seizures

Epileptic Focus Stimulation and Seizure Control in the Rat Model of Kainic Acid-Induced Limbic Seizures

Deep Brain Stimulation for Epilepsy

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

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