Intracranial Stimulation Therapy for Epilepsy

Skarpaas, Tara L.; Morrell, Martha J.

doi:10.1016/j.nurt.2009.01.022

Cited by 107 publications

(56 citation statements)

References 27 publications

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“…Therapeutic closedloop stimulation in the brain is still uncommon. However, analogous approaches are already being tested for epilepsy, and an expanded role for closed-loop systems for deep brain stimulation in Parkinson disease is now being considered (36,37). Further, closed-loop approaches are under development in animal models of spinal cord injury (38,39).…”

Section: Future Applications Of Closed-loop Neuroprostheses For Treatingmentioning

confidence: 99%

Restoration of function after brain damage using a neural prosthesis

Guggenmos

Azin

Barbay

et al. 2013

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

199

182

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Neural interface systems are becoming increasingly more feasible for brain repair strategies. This paper tests the hypothesis that recovery after brain injury can be facilitated by a neural prosthesis serving as a communication link between distant locations in the cerebral cortex. The primary motor area in the cerebral cortex was injured in a rat model of focal brain injury, disrupting communication between motor and somatosensory areas and resulting in impaired reaching and grasping abilities. After implantation of microelectrodes in cerebral cortex, a neural prosthesis discriminated action potentials (spikes) in premotor cortex that triggered electrical stimulation in somatosensory cortex continuously over subsequent weeks. Within 1 wk, while receiving spike-triggered stimulation, rats showed substantially improved reaching and grasping functions that were indistinguishable from prelesion levels by 2 wk. Post hoc analysis of the spikes evoked by the stimulation provides compelling evidence that the neural prosthesis enhanced functional connectivity between the two target areas. This proofof-concept study demonstrates that neural interface systems can be used effectively to bridge damaged neural pathways functionally and promote recovery after brain injury.brain-machine-brain interface | neural plasticity | traumatic brain injury | closed-loop | long-term potentiation T he view of the brain as a collection of independent anatomical modules, each with discrete functions, is currently undergoing radical change. New evidence from neurophysiological and neuroanatomical experiments in animals, as well as neuroimaging studies in humans, now suggests that normal brain function can be best appreciated in the context of the complex arrangements of functional and structural interconnections among brain areas. Although mechanistic details are still under refinement, synchronous discharge of neurons in widespread areas of the cerebral cortex appears to be an emergent property of neuronal networks that functionally couple remote locations (1). It is now recognized that not only are discrete regions of the brain damaged in injury or disease but, perhaps more importantly, the interconnections among uninjured areas are disrupted, potentially leading to many of the functional impairments that persist after brain injury (2). Likewise, plasticity of brain interconnections may partially underlie recovery of function after injury (3).Technological efforts to restore brain function after injury have focused primarily on modulating the excitability of focal regions in uninjured parts of the brain (4). Purportedly, increasing the excitability of neurons involved in adaptive plasticity expands the neural substrate potentially involved in functional recovery. However, no methods are yet available to alter the functional connectivity between spared brain regions directly, with the intent to restore normal communication patterns. The present paper tests the hypothesis that an artificial communication link between uninjured regions of the...

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Section: Future Applications Of Closed-loop Neuroprostheses For Treatingmentioning

confidence: 99%

Restoration of function after brain damage using a neural prosthesis

Guggenmos

Azin

Barbay

et al. 2013

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

199

182

View full text Add to dashboard Cite

show abstract

“…For instance, the frontal lobe is highly associated with problem solving, mental flexibility, judgment, creativity, foresightedness and deficiencies; whereas the temporal lobe is primarily responsible for auditory sensation, perception, language comprehension, long-term memory and sexual behavior. EEG data can be analyzed to assess mental states and neuronal activities of neurological disorder patients [41]. For epilepsy neurological disorder patients, ictal episodes captured in EEG data shows increased level of uncontrolled activity of brain signals typically characterized by increases in Gamma rhythms [42].…”

Section: Electroencephalography (Eeg)mentioning

confidence: 99%

A Brief Review of Brain Signal Monitoring Technologies for BCI Applications: Challenges and Prospects

Morshed¹

2014

J Bioeng Biomed Sci

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Significant strides have been made since 1940s for monitoring brain activities and utilizing the information for diagnosis, therapy, and control of robotic instruments including prosthetics. Monitoring brain activities with brain computer interfacing (BCI) technologies are of recent interest to due to the immense potential for various medical applications, particularly for many neurological disorder patients, and the emergence of technologies suitable for long duration BCI applications. Recent initiatives are geared towards transforming these clinic centric technologies to patient centric technologies by monitoring brain activities in practical settings. This paper briefly reviews current status of these technologies and relevant challenges. The technologies can be broadly classified into non-invasive (EEG, MEG, MRI) and invasive (Microelectrode, ECoG, MEA). Challenges to resolve include neuronal damage, neurotrophicity, usability and comfort.

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“…A study is currently underway in the United States to assess the effectiveness of an intracranial "pacemaker" which triggers electrical stimulation in response to the detection of an ongoing seizure through intracerebral electrodes [54,55]. This system, the NeuroPace RNS system (Mountain View, CA, USA), is being evaluated for medically refractory partial-onset epilepsy (Clinicaltrials.gov NCT00264810) [56].…”

Section: Dbs Closed-loop Systemsmentioning

confidence: 99%

Possible new avenues in epilepsy treatment: the stimulation techniques deep brain stimulation, vagal nerve stimulation, transcranial magnetic stimulation

Boëx

Brodbeck²,

Vulliémoz³

et al. 2011

Swiss Arch Neurol Psychiatr

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SummaryStimulation techniques have been extensively explored as new treatments for epilepsy, and their efficacy is still being investigated, albeit several approaches appear to be very promising. Vagal nerve stimulation (VNS) has been a well established palliative therapy for almost 20 years, however, complete seizure control is rarely obtained. Its favourable effect on mood has been noted in several studies, and VNS was FDA-approved for the treatment of major depression in 2005. Intracerebral electrical stimulation is currently being evaluated as apotential treatment for patients with drug-resistantfocal epilepsy in whom surgery cannot be offered. We summarise the results of various studies applying deep brain stimulation (DBS) to different brain structures, particularly to the mesial temporal lobe. From these studies, it appears that the efficiency of DBS to reduce epileptic seizures is demonstrated in a sufficiently large patient population but the exact determinants (physical parameters, syndromes) of its success (or its absence) remain unknown. Repetitive Transcranial Magnetic Stimulation (rTMS) has been investigated as an antiepileptic treatment in patients with focal seizure onset by several groups, however, the clinical success is variable and in most studies rather low.

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Intracranial Stimulation Therapy for Epilepsy

Cited by 107 publications

References 27 publications

Restoration of function after brain damage using a neural prosthesis

Restoration of function after brain damage using a neural prosthesis

A Brief Review of Brain Signal Monitoring Technologies for BCI Applications: Challenges and Prospects

Possible new avenues in epilepsy treatment: the stimulation techniques deep brain stimulation, vagal nerve stimulation, transcranial magnetic stimulation

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