Therapeutic devices for epilepsy

Fisher, Robert S.

doi:10.1002/ana.22621

Cited by 111 publications

(83 citation statements)

References 112 publications

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“…However, patients diagnosed with other forms of epilepsy who do not benefit sufficiently from medication may be eligible for (cerebellar) DBS 47. Currently, the options for applying DBS are limited; only the anterior thalamic nucleus is currently described in the US Food and Drug Administration guidelines to treat intractable epilepsy, and although promising, the outcome is limited and can result in cognitive and emotional problems 72, 73. Given the powerful impact of CN stimulation on thalamocortical activity that is shown in the present study, we hypothesize that CN stimulation may also exert very positive effects in these other, more severe kinds of epilepsies.…”

Section: Discussionmentioning

confidence: 99%

Cerebellar output controls generalized spike‐and‐wave discharge occurrence

Kros

Rooda

Spanke

et al. 2015

Annals of Neurology

121

138

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ObjectiveDisrupting thalamocortical activity patterns has proven to be a promising approach to stop generalized spike‐and‐wave discharges (GSWDs) characteristic of absence seizures. Here, we investigated to what extent modulation of neuronal firing in cerebellar nuclei (CN), which are anatomically in an advantageous position to disrupt cortical oscillations through their innervation of a wide variety of thalamic nuclei, is effective in controlling absence seizures.MethodsTwo unrelated mouse models of generalized absence seizures were used: the natural mutant tottering, which is characterized by a missense mutation in Cacna1a, and inbred C3H/HeOuJ. While simultaneously recording single CN neuron activity and electrocorticogram in awake animals, we investigated to what extent pharmacologically increased or decreased CN neuron activity could modulate GSWD occurrence as well as short‐lasting, on‐demand CN stimulation could disrupt epileptic seizures.ResultsWe found that a subset of CN neurons show phase‐locked oscillatory firing during GSWDs and that manipulating this activity modulates GSWD occurrence. Inhibiting CN neuron action potential firing by local application of the γ‐aminobutyric acid type A (GABA‐A) agonist muscimol increased GSWD occurrence up to 37‐fold, whereas increasing the frequency and regularity of CN neuron firing with the use of GABA‐A antagonist gabazine decimated its occurrence. A single short‐lasting (30–300 milliseconds) optogenetic stimulation of CN neuron activity abruptly stopped GSWDs, even when applied unilaterally. Using a closed‐loop system, GSWDs were detected and stopped within 500 milliseconds.InterpretationCN neurons are potent modulators of pathological oscillations in thalamocortical network activity during absence seizures, and their potential therapeutic benefit for controlling other types of generalized epilepsies should be evaluated. Ann Neurol 2015;77:1027–1049

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Section: Discussionmentioning

confidence: 99%

Cerebellar output controls generalized spike‐and‐wave discharge occurrence

Kros

Rooda

Spanke

et al. 2015

Annals of Neurology

121

138

View full text Add to dashboard Cite

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“…This technique uses light-activated microbial proteins such as Channelrhodopsin 2 (ChR2), which depolarizes neurons when illuminated with blue light, or Halorhodopsin (NpHR), which hyperpolarizes neurons (21,28,29). Optogenetic approaches have been used in rodents to probe neuronal circuits for several neurological/neurodegenerative diseases, including Parkinson disease (30) and epilepsy (31). Recent studies have also used optogenetics to map functional organization after stroke (32)(33)(34)(35).…”

mentioning

confidence: 99%

Optogenetic neuronal stimulation promotes functional recovery after stroke

Cheng

Wang

Woodson

et al. 2014

Proc. Natl. Acad. Sci. U.S.A.

178

205

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Clinical and research efforts have focused on promoting functional recovery after stroke. Brain stimulation strategies are particularly promising because they allow direct manipulation of the target area's excitability. However, elucidating the cell type and mechanisms mediating recovery has been difficult because existing stimulation techniques nonspecifically target all cell types near the stimulated site. To circumvent these barriers, we used optogenetics to selectively activate neurons that express channelrhodopsin 2 and demonstrated that selective neuronal stimulations in the ipsilesional primary motor cortex (iM1) can promote functional recovery. Stroke mice that received repeated neuronal stimulations exhibited significant improvement in cerebral blood flow and the neurovascular coupling response, as well as increased expression of activity-dependent neurotrophins in the contralesional cortex, including brain-derived neurotrophic factor, nerve growth factor, and neurotrophin 3. Western analysis also indicated that stimulated mice exhibited a significant increase in the expression of a plasticity marker growth-associated protein 43. Moreover, iM1 neuronal stimulations promoted functional recovery, as stimulated stroke mice showed faster weight gain and performed significantly better in sensory-motor behavior tests. Interestingly, stimulations in normal nonstroke mice did not alter motor behavior or neurotrophin expression, suggesting that the prorecovery effect of selective neuronal stimulations is dependent on the poststroke environment. These results demonstrate that stimulation of neurons in the stroke hemisphere is sufficient to promote recovery. stroke recovery | channelrhodopsin

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“…The effect of structured auditory stimuli provides non-invasive galvanic cortex stimulation, which can reduce epileptiform activity. (32) To prove this hypothesis, researchers conducted a randomized study, which explored the effectiveness of music therapy for patients diagnosed with epilepsy. (33) Patients were exposed to Mozart's music every night for one year.…”

Section: Psychotherapeutic Optionsmentioning

confidence: 99%

The Role of Non-Drug Treatment Methods in the Management of Epilepsy

Narodova¹,

Shnayder²,

Narodova³

et al. 2018

IJBM

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This review is dedicated to the issue of non-pharmacological treatment of epilepsy in the adult population in Russia and other countries. A literature review was conducted using international databases for the period between 2010 and 2017. A total of 64 full-text editions were included in this review, which allowed us to reveal the basic non-pharmacological epilepsy treatment options. However, not all of these options have a sufficient evidence base, and some of them are not always safe. Particularly, methods with a low level of evidence include acupuncture and aromatherapy. Further studies are needed to explore the methods aimed at eliminating the dominant epileptic system through the development of a new, more powerful dominant system. One of the methods that can influence the pathogenesis of epilepsy is physical activity for patients with epilepsy, since epileptiform activity is reported to disappear from the EEG during exercises. The positive results of the application of music therapy are also described in the modern literature. Specifically, according to the results of some studies, the positive effect of reducing the frequency of seizures was achieved in epileptic patients who listened to music during sleep over a year. However, these studies are not numerous, so they cannot constitute a high level of evidence. Therefore, care should be exercised in applying these methods in epileptic patients. (International Journal of Biomedicine. 2018;8(1):9-14.)

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Therapeutic devices for epilepsy

Cited by 111 publications

References 112 publications

Cerebellar output controls generalized spike‐and‐wave discharge occurrence

Cerebellar output controls generalized spike‐and‐wave discharge occurrence

Optogenetic neuronal stimulation promotes functional recovery after stroke

The Role of Non-Drug Treatment Methods in the Management of Epilepsy

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