Neuro-stimulation in focal epilepsy: A systematic review and meta-analysis

Skrehot, Henry C.; Englot, Dario J.; Haneef, Zulfi

doi:10.1016/j.yebeh.2023.109182

“…Additionally, the interplay between neural activity and ion concentration changes in localized seizures has been elucidated by Gentiletti et al ( 2022 ), stressing the critical role of computational methods in deciphering complex neurophysiological processes. Nowadays there are already several devices (approved by the U.S. Food and Drug Administration) aiming to reduce the frequency of seizures, namely Vagus Nerve Stimulation (VNS), Responsive Neurostimulation (RNS), and Deep Brain Stimulation (DBS) (see Skrehot et al, 2023 and references therein for a recent review). Here again the weight decrease may give a hint on the location of the stimulation efficiency.…”

Section: Discussionmentioning

confidence: 99%

An exploratory computational analysis in mice brain networks of widespread epileptic seizure onset locations along with potential strategies for effective intervention and propagation control

Courson,

Quoy,

Timofeeva

et al. 2024

Front. Comput. Neurosci.

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Mean-field models have been developed to replicate key features of epileptic seizure dynamics. However, the precise mechanisms and the role of the brain area responsible for seizure onset and propagation remain incompletely understood. In this study, we employ computational methods within The Virtual Brain framework and the Epileptor model to explore how the location and connectivity of an Epileptogenic Zone (EZ) in a mouse brain are related to focal seizures (seizures that start in one brain area and may or may not remain localized), with a specific focus on the hippocampal region known for its association with epileptic seizures. We then devise computational strategies to confine seizures (prevent widespread propagation), simulating medical-like treatments such as tissue resection and the application of an anti-seizure drugs or neurostimulation to suppress hyperexcitability. Through selectively removing (blocking) specific connections informed by the structural connectome and graph network measurements or by locally reducing outgoing connection weights of EZ areas, we demonstrate that seizures can be kept constrained around the EZ region. We successfully identified the minimal connections necessary to prevent widespread seizures, with a particular focus on minimizing surgical or medical intervention while simultaneously preserving the original structural connectivity and maximizing brain functionality.

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“…Additionally, the interplay between neural activity and ion concentration changes in localized seizures has been elucidated by (Gentiletti et al, 2022), stressing the critical role of computational methods in deciphering complex neurophysiological processes. Nowadays there are already several devices (approved by the U.S. Food and Drug Administration) aiming to reduce the frequency of seizures, namely Vagus Nerve Stimulation (VNS), Responsive Neurostimulation (RNS), and Deep Brain Stimulation (DBS) (see (Skrehot et al, 2023) and references therein for a recent review). Here again the weight decrease may give a hint on the location of the stimulation efficiency.…”

Section: Discussionmentioning

confidence: 99%

An exploratory computational analysis in mice brain networks of widespread epileptic seizure onset locations along with potential strategies for effective intervention and propagation control

Courson,

Quoy,

Timofeeva

et al. 2023

Preprint

0

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Mean-field models have been developed to replicate key features of epileptic seizure dynamics. However, the precise mechanisms and the role of the brain area responsible for seizure onset and propagation remain incompletely understood. In this study, we employ computational methods within The Virtual Brain framework and the Epileptor model to explore how the location and connectivity of an Epileptogenic Zone (EZ) in a mouse brain are related to focal seizures (seizures that start in one brain area and may or may not remain localized), with a specific focus on the hippocampal region known for its association with epileptic seizures. We then devise computational strategies to confine seizures (prevent widespread propagation), simulating medical-like treatments such as tissue resection and the application of an anti-seizure drugs or neurostimulation to suppress hyperexcitability. Through selectively removing (blocking) specific connections informed by the structural connectome and graph network measurements or by locally reducing outgoing connection weights of EZ areas, we demonstrate that seizures can be kept constrained around the EZ region. We successfully identified the minimal connections necessary to prevent widespread seizures, with a particular focus on minimizing surgical or medical intervention while simultaneously preserving the original structural connectivity and maximizing brain functionality.

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“…Another study that followed 44 adults and 21 children over a long period reported that the 50% responder rate gradually increased and reached approximately 75% (Figure 4) [20]. Furthermore, a recent meta-analysis study indicated that seizure reduction (50% responder rate) for the VNS devices at years one, two, and three were VNS 32.9%, 44.4%, and 53.5%, respectively [21]. As described below, the efficacy and safety reported for children are approximately the same as those for adults.…”

Section: Seizure Suppression Effectmentioning

confidence: 99%

Vagus Nerve Stimulation Therapy for Drug-Resistant Epilepsy in Children—A Literature Review

Fukuda,

Matsuo,

Fujimoto

et al. 2024

JCM

2

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Vagus nerve stimulation (VNS) is a palliative treatment for drug-resistant epilepsy (DRE) that has been in use for over two decades. VNS suppresses epileptic seizures, prevents emotional disorders, and improves cognitive function and sleep quality, a parallel effect associated with the control of epileptic seizures. The seizure suppression rate with VNS increases monthly to annually, and the incidence of side effects reduces over time. This method is effective in treating DRE in children as well as adults, such as epilepsy associated with tuberous sclerosis, Dravet syndrome, and Lennox–Gastaut syndrome. In children, it has been reported that seizures decreased by >70% approximately 8 years after initiating VNS, and the 50% responder rate was reported to be approximately 70%. VNS regulates stimulation and has multiple useful systems, including self-seizure suppression using magnets, additional stimulation using an automatic seizure detection system, different stimulation settings for day and night, and an automatic stimulation adjustment system that reduces hospital visits. VNS suppresses seizures and has beneficial behavioral effects in children with DRE. This review describes the VNS system, the mechanism of the therapeutic effect, the specific stimulation adjustment method, antiepileptic effects, and other clinical effects in patients with childhood DRE.

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Neuro-stimulation in focal epilepsy: A systematic review and meta-analysis

Cited by 18 publications

References 54 publications

An exploratory computational analysis in mice brain networks of widespread epileptic seizure onset locations along with potential strategies for effective intervention and propagation control

An exploratory computational analysis in mice brain networks of widespread epileptic seizure onset locations along with potential strategies for effective intervention and propagation control

An exploratory computational analysis in mice brain networks of widespread epileptic seizure onset locations along with potential strategies for effective intervention and propagation control

Vagus Nerve Stimulation Therapy for Drug-Resistant Epilepsy in Children—A Literature Review

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