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Related Experiment Video

Updated: Jun 18, 2025

Analysis of Gene Expression Changes in the Rat Hippocampus After Deep Brain Stimulation of the Anterior Thalamic Nucleus
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CM-Pf deep brain stimulation in polyneuromodulation for epilepsy.

W O Tatum1, B Freund1, E H Middlebrooks2

  • 1Department of Neurology, Mayo Clinic, Jacksonville, Florida, USA.

Epileptic Disorders : International Epilepsy Journal with Videotape
|July 30, 2024
PubMed
Summary
This summary is machine-generated.

Combining neuromodulation devices like vagus nerve stimulation (VNS), responsive neurostimulation (RNS), and deep brain stimulation (DBS) is safe and effective for drug-resistant epilepsy. A triple implant, including CM-Pf DBS, significantly reduced seizures in a unique case.

Keywords:
centromedian‐parafascicularisdeep brain stimulationdevicesdrug resistanceepilepsyneuromodulationneurostimulatorsseizuressurgerythalamus

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Area of Science:

  • Neurology
  • Neurosurgery
  • Biomedical Engineering

Background:

  • Drug-resistant epilepsies present significant management challenges.
  • Neuromodulation offers a viable treatment option for refractory epilepsy.
  • Combinations of neurostimulation devices are increasingly explored.

Purpose of the Study:

  • To review the management of patients with multiple neurostimulators for drug-resistant epilepsy.
  • To present an illustrative case of a triple implant including CM-Pf DBS.
  • To evaluate the safety and efficacy of combined neuromodulation strategies.

Main Methods:

  • A narrative review of PubMed and Embase databases.
  • Identification of patients with dual or triple neurostimulator implants (VNS, DBS, RNS).
  • Detailed reporting of a unique case with VNS, RNS, and CM-Pf DBS.

Main Results:

  • Dual-device therapy for drug-resistant epilepsy is increasingly reported.
  • CM-Pf DBS is a novel target with variable responses in focal epilepsy.
  • A 28-year-old male achieved 75% seizure reduction and seizure freedom with a triple implant (VNS, RNS, CM-Pf DBS), with no complications.

Conclusions:

  • Combining VNS, RNS, and CM-Pf DBS is safe and feasible in adults.
  • Suboptimal response to initial neuromodulation does not indicate failure; combination strategies are effective.
  • Successful implementation of multi-device neuromodulation requires understanding of brain networks.