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Neuromodulation strategies in developmental and epileptic encephalopathies
Debopam Samanta1, Zulfi Haneef2, Gregory W Albert3
1Division of Child Neurology, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Epilepsy & Behavior : E&B
|October 11, 2024
Summary
Developmental and epileptic encephalopathies (DEEs) are challenging childhood epilepsies. Network-based neuromodulation, like deep brain stimulation (DBS), shows promise but requires personalized approaches for better outcomes.
Area of Science:
- Neurology
- Neuroscience
- Epileptology
Background:
- Developmental and epileptic encephalopathies (DEEs) are severe childhood epilepsies with limited treatment options.
- Neuromodulation, including deep brain stimulation (DBS) and responsive neurostimulation (RNS), is emerging for refractory DEEs.
- Understanding syndrome-specific brain networks is crucial for optimizing neuromodulation.
Purpose of the Study:
- To review neuroimaging findings on epileptic networks in DEEs.
- To explore the role of thalamic DBS in Lennox-Gastaut Syndrome (LGS) as a model for network-based neuromodulation.
- To identify future research directions for enhancing neuromodulation efficacy in DEEs.
Main Methods:
- Review of neuroimaging studies on DEE-related brain networks.
- Examination of centromedian thalamic DBS for LGS.
- Analysis of DBS and RNS applications in various DEE etiologies.
Main Results:
- DEEs share common network involvement, including the thalamus and default-mode network (DMN).
- Thalamic DBS for LGS shows modest efficacy, highlighting variability in response.
- Current neuromodulation approaches for DEEs yield mixed results, indicating a need for refinement.
Conclusions:
- Network insights are vital for optimizing neuromodulation in DEEs.
- Personalized, network-based strategies, potentially using LGS as a model, are needed for DEEs.
- Future research should focus on individualized connectivity and biomarkers to improve neuromodulation outcomes.
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