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Related Concept Videos

Electroconvulsive Therapy01:30

Electroconvulsive Therapy

Electroconvulsive therapy (ECT), or shock therapy, remains a critical biomedical intervention for severe, treatment-resistant depression. While its origins can be traced back to Hippocrates' observations that malaria-induced convulsions alleviated mental illness, modern ECT has evolved significantly from its earlier, more primitive applications. First introduced in 1938 by Ugo Cerletti and his colleagues, ECT involves inducing controlled seizures using electrical currents. In its early years,...

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[Invasive neurostimulation as adjunct treatment for epilepsy].

G Möddel1, V A Coenen, C E Elger

  • 1Klinik für Epileptologie, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Deutschland. Gabriel.moeddel@ukb.uni-bonn.de

Der Nervenarzt
|July 18, 2012
PubMed
Summary
This summary is machine-generated.

Neurostimulation, including vagus nerve stimulation (VNS), anterior nucleus of the thalamus deep brain stimulation (ANT-DBS), and responsive neurostimulation (RNS), effectively reduces epileptic seizure frequency and severity.

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Area of Science:

  • Neurology
  • Neurosurgery
  • Biomedical Engineering

Context:

  • Epilepsy management remains a challenge, necessitating advanced therapeutic strategies.
  • Neurostimulation offers a promising avenue for refractory epilepsy.
  • Current evidence reviews established and emerging neurostimulation techniques.

Purpose:

  • To evaluate the efficacy and side-effect profiles of Vagus Nerve Stimulation (VNS), Anterior Nucleus Deep Brain Stimulation (ANT-DBS), and Responsive Neurostimulation (RNS) for epilepsy treatment.
  • To compare these interventions against placebo or control groups.
  • To identify patient subgroups that may benefit most from specific neurostimulation modalities.

Summary:

  • Vagus nerve stimulation (VNS) demonstrated a 25-28% seizure reduction versus 6-15% in controls, with open-label studies suggesting higher efficacy.
  • Anterior nucleus deep brain stimulation (ANT-DBS) showed a 40.4% seizure reduction in a randomized controlled trial, particularly in patients with temporal seizure onset, with 13% achieving seizure freedom.
  • Responsive neurostimulation (RNS) resulted in a 37.9% seizure reduction compared to 17.3% in controls, with no significant neuropsychological or psychiatric side-effects.

Impact:

  • Neurostimulation techniques provide significant seizure reduction for epilepsy patients.
  • ANT-DBS and RNS present viable therapeutic options with distinct efficacy and safety profiles.
  • Further research into personalized neurostimulation approaches is warranted.