Survival analysis of nonperiodic stimulation (NPS) performance

Electrical Stimulation (ES) of the nervous system is a promising alternative to treat refractory epilepsy. Recent developments in the area have led to a novel method involving a non-standard form of electrical stimulation with randomized inter-pulse intervals called non-periodic stimulation (NPS). Although it is an interesting approach, there is limited statistical proof to confirm its effectiveness. Therefore this brief communication presents a survival analysis of a pre-clinical trial to assess the significance of NPS therapy. The experiment comprised four groups of rats that have been compared: two with and two without NPS treatment. ES was applied bilaterally to the amygdala in animals subjected to the pentylenetetrazole continuous infusion (10 mg/ml/min) model, myoclonic or tonic-clonic generalized seizures were triggered. The Kaplan-Meier estimator was used to develop survival functions and the Logrank test was carried out to check the differences among groups. The first comparison was made between two groups of rats that developed generalized tonic-clonic seizures (GTC groups), those who received NPS treatment took longer to develop epileptic seizures. The logrank test proved statistical difference due to reaching a p-value of 7%. The second comparison was performed between two groups of rats that developed myoclonic seizures (MYO groups), and once again better survival probabilities were observed for the NPS group. The Logrank test revealed a p-value of 0.5% thereof. Thus, a survival analysis of NPS treatment proved effectiveness against seizures by promoting an anticonvulsant effect. By comparing the groups selected for this study, it was found that the NPS treatment yielded better results, mainly against myoclonic seizures.