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Responsive neurostimulation with low-frequency stimulation.

Juan Luis Alcala-Zermeno1, Keith Starnes2, Nicholas M Gregg1

  • 1Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA.

Epilepsia
|November 17, 2022
PubMed
Summary
This summary is machine-generated.

Low-frequency stimulation (LFS) shows promise for treating focal drug-resistant epilepsy. Responsive neurostimulation (RNS) with LFS significantly reduced seizures compared to high-frequency stimulation (HFS) in a case series.

Keywords:
alternative parameterslow-frequency stimulationneuromodulationneurostimulationresponsive neurostimulation

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Area of Science:

  • Neurology
  • Neurosurgery
  • Biomedical Engineering

Background:

  • Responsive neurostimulation (RNS) and deep brain stimulation (DBS) typically use high-frequency stimulation (HFS).
  • Not all epilepsy patients respond effectively to HFS protocols.
  • Investigating alternative stimulation parameters is crucial for optimizing neuromodulation therapies.

Purpose of the Study:

  • To evaluate the efficacy and safety of low-frequency stimulation (LFS) in patients with focal drug-resistant epilepsy treated with the RNS System.
  • To compare seizure reduction achieved with LFS versus HFS.

Main Methods:

  • A retrospective case series of 10 patients implanted with the RNS System.
  • Patients were programmed with LFS (<10 Hz) with increased burst duration (≥1000 ms), with nine previously treated with HFS (≥100 Hz).
  • Seizure reduction was compared between LFS and HFS, and against baseline.

Main Results:

  • LFS achieved a median seizure reduction (MSR) of 67% compared to HFS and 76% compared to baseline.
  • HFS resulted in a median seizure reduction of only 13%.
  • No LFS-specific adverse effects were reported; stimulation parameters like charge and pulses per day were similar, but daily stimulation time was longer for LFS.

Conclusions:

  • Low-frequency stimulation (LFS) is a potentially effective and safe alternative for focal drug-resistant epilepsy patients using the RNS System.
  • LFS offers a significant improvement in seizure control for patients unresponsive to HFS.
  • Further research into LFS parameters could enhance neuromodulation strategies for epilepsy.