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Emerging approaches in neurostimulation for epilepsy.
Brian Nils Lundstrom1, Gamaleldin M Osman1, Keith Starnes1
1Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA.
Current Opinion in Neurology
|February 10, 2023
Summary
Neurostimulation offers diverse, innovative epilepsy treatments, including invasive and noninvasive brain stimulation. Future advancements focus on new targets, pediatric care, and improved hardware for better patient outcomes.
Area of Science:
- Neuroscience
- Neurology
- Bioelectronic Medicine
Background:
- Epilepsy treatment is evolving with neurostimulation, a rapidly growing therapeutic approach.
- Current invasive methods include vagus nerve, responsive cortical, and deep brain stimulation.
Approach:
- Review of recent invasive and noninvasive neurostimulation techniques for epilepsy.
- Exploration of novel targets such as thalamic nuclei, medial septum, and cerebellum.
- Emerging hardware with implantable leads and sensing capabilities.
Key Points:
- Vagus nerve stimulation, responsive neurostimulation, and deep brain stimulation are established invasive options.
- Investigational targets include thalamic nuclei, nucleus accumbens, and piriform cortex.
- Noninvasive brain stimulation presents a favorable risk profile for broader patient application.
Conclusions:
- Neurostimulation provides flexible and reversible epilepsy treatment options.
- Continued development of excitability biomarkers is crucial for guiding innovation.
- Bioelectronic medicine offers unique benefits and challenges in epilepsy management.
