Opportunities for Electroceuticals in Epilepsy

Publication date: Available online 5 September 2019Source: Trends in Pharmacological SciencesAuthor(s): Omid Kavehei, Tara Julia Hamilton, Nhan Duy Truong, Armin NikpourEpilepsy is a neurological disorder that affects ~1% of the world population. Nearly 30% of epilepsy patients suffer from pharmacoresistant epilepsy that cannot be treated with antiepileptic drugs. Depending on seizure type, a diverse range of therapies are available, including surgery, vagus nerve stimulation, and deep brain stimulation. We review the sensing and stimulation technologies most used in neurological disorders, and provide a vision of minimally invasive electroceuticals to enable accurate forecasting of epileptic seizures and therapy. The use of such systems could potentially help patients to prevent injuries and, in combination with an intervention mechanism, could provide a method of suppressing seizures in epileptic patients.
Source: Trends in Pharmacological Sciences - Category: Drugs & Pharmacology Source Type: research

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ConclusionOur results suggest that pulsed FUS exposure effectively suppresses epileptic spikes in an acute epilepsy animal model, and finds that ultrasound pulsation interferes with neuronal activity and affects the PTZ-induced PI3K-Akt-mTOR pathway, which might help explain the mechanism underlying ultrasound-related epileptic spike control.
Source: Brain Stimulation - Category: Neurology Source Type: research
ConclusionOur results suggest that pulsed FUS exposure effectively suppresses epileptic spikes in an acute epilepsy animal model, and finds that ultrasound pulsation interferes with neuronal activity and affects the PTZ-induced PI3K-Akt-mTOR pathway, which might help explain the mechanism underlying ultrasound-related epileptic spike control.
Source: Brain Stimulation - Category: Neurology Source Type: research
Epilepsy is a neurological disorder characterized by abnormal neuron discharge, and one-third of epilepsy patients suffer from drug-resistant epilepsy (DRE). The current management for DRE includes epileptogenic lesion resection, disconnection, and neuromodulation. Neuromodulation is achieved through invasive electrical stimulus including deep brain stimulation, vagus nerve stimulation, or responsive neurostimulation (RNS). As an alternative therapy, transcranial focused ultrasound (FUS) can transcranially and non-invasively modulate neuron activity.
Source: BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation - Category: Neurology Authors: Source Type: research
Authors: Phi JH, Cho BK Abstract Epilepsy has been known to humankind since antiquity. The surgical treatment of epilepsy began in the early days of neurosurgery and has developed greatly. Many surgical procedures have stood the test of time. However, clinicians treating epilepsy patients are now witnessing a huge tide of change. In 2017, the classification system for seizure and epilepsy types was revised nearly 36 years after the previous scheme was released. The actual difference between these systems may not be large, but there have been many conceptual changes, and clinicians must bid farewell to old terminolo...
Source: Journal of Korean Neurosurgical Society - Category: Neurosurgery Tags: J Korean Neurosurg Soc Source Type: research
AbstractImplantable neural stimulators represent an advanced treatment adjunct to medication for pharmacoresistant epilepsy and alternative for patients that are not good candidates for resective surgery. Three treatment modalities are currently FDA-approved: vagus nerve stimulation, responsive neurostimulation, and deep brain stimulation. These devices were originally trialed in very similar patient populations with focal epilepsy, but head-to-head comparison trials have not been performed. As such, device selection may be challenging due to large overlaps in clinical indications and efficacy. Here we will review the data...
Source: Neurotherapeutics - Category: Neurology Source Type: research
Conclusion: We present a new statistical model with which EEG reactivity to external stimuli during routine presurgical evaluation can be seen as a promising avenue for the identification of patients with favorable VNS outcome. This novel method for the prediction of VNS efficacy might represent a breakthrough in the management of drug-resistant epilepsy, with wide-reaching medical and economic implications. Introduction Resective surgery is currently the best therapeutic option for treatment of patients with drug-resistant epilepsy, but a substantial number of intractable patients remains who are ineligible for such...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Conclusion Despite the above limitations, this systematic review supports a view that modulation of sympathetic activity using GSR biofeedback represents a promising new therapeutic tool for management of seizures in patients with epilepsy. For future clinical trials, important elements to be considered include size of patient population, seizure type, double-blinding, inclusion of an appropriate control group, and robust randomization methods. Ethics Statement We confirm that we have read the Journal's position on issues involved in ethical publication and affirm that this report is consistent with those guidel...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Authors: Markert MS, Fisher RS Abstract INTRODUCTION: Neuromodulation devices can be safe and effective for the treatment of drug-resistant epilepsy. A body of scientific work supports peripheral, subcortical and cortical targets, each with different fundamental methods of action. Areas covered: High-quality evidence is available for vagal nerve stimulation (VNS), deep brain stimulation (DBS), and responsive neurostimulation (RNS). Mechanistic research in animals and human studies are reviewed, along with key data from VNS, DBS, and RNS clinical trials. Specifically, the authors review some of the science behind the m...
Source: Expert Review of Neurotherapeutics - Category: Neurology Tags: Expert Rev Neurother Source Type: research
ConclusionsProperly designed questionnaires – like the FST-questionnaire as standardized assessment tool – can detect changes in self-perception in patients during neurostimulatory treatment in a wide spectrum of brain stimulation techniques. This may provide a strategy to systematically identify the subgroup of patients liable to experience such problems during treatment already prior to treatment decisions.
Source: Epilepsy and Behavior - Category: Neurology Source Type: research
CONCLUSIONS: Properly designed questionnaires - like the FST-questionnaire as standardized assessment tool - can detect changes in self-perception in patients during neurostimulatory treatment in a wide spectrum of brain stimulation techniques. This may provide a strategy to systematically identify the subgroup of patients liable to experience such problems during treatment already prior to treatment decisions. PMID: 30500485 [PubMed - as supplied by publisher]
Source: Epilepsy and Behaviour - Category: Neurology Authors: Tags: Epilepsy Behav Source Type: research
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