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Related Experiment Video

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Analysis of Gene Expression Changes in the Rat Hippocampus After Deep Brain Stimulation of the Anterior Thalamic Nucleus
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Deep brain and cortical stimulation for epilepsy.

Mathieu Sprengers1, Kristl Vonck, Evelien Carrette

  • 1Department of Neurology, Ghent University Hospital, 1K12, 185 De Pintelaan, Ghent, Belgium, B-9000.

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|July 19, 2017
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This summary is machine-generated.

Deep brain stimulation (DBS) and cortical stimulation moderately reduce seizure frequency in refractory epilepsy patients. However, anterior thalamic DBS is linked to increased depression and memory issues, necessitating further research.

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Area of Science:

  • Neurology
  • Neurosurgery
  • Epilepsy Research

Background:

  • Refractory epilepsy often persists despite optimal medical and surgical treatments.
  • Intracranial neurostimulation, including deep brain stimulation (DBS) and cortical stimulation, has emerged as a potential therapeutic option.
  • This review updates previous findings on neurostimulation for epilepsy.

Purpose of the Study:

  • To evaluate the efficacy, safety, and tolerability of DBS and cortical stimulation for refractory epilepsy.
  • To analyze data from randomized controlled trials (RCTs) to assess treatment outcomes.

Main Methods:

  • Searched multiple databases (CENTRAL, PubMed, ClinicalTrials.gov, ICTRP) and contacted researchers for relevant RCTs.
  • Included RCTs comparing intracranial stimulation (DBS or cortical) with sham stimulation, surgery, or other treatments.
  • Extracted data on seizure freedom, responder rates, seizure frequency reduction, adverse events, neuropsychological outcomes, and quality of life.

Main Results:

  • Twelve RCTs were identified, primarily comparing short-term (1-3 months) stimulation with sham.
  • Anterior thalamic DBS, responsive ictal onset zone stimulation, and hippocampal DBS showed statistically significant reductions in seizure frequency.
  • Anterior thalamic DBS was associated with higher rates of self-reported depression and memory impairment; safety and efficacy for other targets (centromedian thalamic, cerebellar, nucleus accumbens DBS) remain uncertain due to low-quality evidence.

Conclusions:

  • Short-term anterior thalamic DBS, responsive ictal onset zone stimulation, and hippocampal DBS can moderately reduce seizure frequency in refractory epilepsy.
  • Anterior thalamic DBS presents risks of depression and subjective memory impairment.
  • Further large, well-designed RCTs are needed to confirm efficacy and safety of various intracranial neurostimulation techniques.