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Performing Behavioral Tasks in Subjects with Intracranial Electrodes

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Invasive Neurostimulation for the Treatment of Epilepsy.

Shirin Jamal Omidi¹, Brian Nils Lundstrom¹

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

Seminars in Neurology

|March 19, 2025

Summary

Bioelectronic medicine, using vagus nerve stimulation (VNS), responsive neurostimulation (RNS), and deep brain stimulation (DBS), offers new epilepsy treatment options by reducing seizures. Further research is needed for personalized protocols and curative potential.

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Area of Science:

Neuroscience
Biomedical Engineering
Neurology

Background:

Bioelectronic medicine leverages electrical stimulation for therapeutic purposes.
Invasive neurostimulation techniques like VNS, RNS, and DBS are increasingly used for epilepsy treatment.
Current methods, while effective in reducing seizure burden, are typically noncurative.

Purpose of the Study:

To review current invasive neurostimulation approaches for epilepsy.
To highlight the differences in targets and stimulation parameters among VNS, RNS, and DBS.
To identify areas for future research in bioelectronic medicine for epilepsy.

Main Methods:

Review of existing literature on VNS, RNS, and DBS for epilepsy.
Comparison of neurostimulation targets (cranial nerve, cortex, thalamus).
Analysis of stimulation parameters (triggered vs. continuous).

Main Results:

VNS, RNS, and DBS offer significant seizure reduction for epilepsy patients.
These methods provide alternative treatment options when other therapies fail.
Optimal targets and individualized stimulation protocols require further investigation.

Conclusions:

Bioelectronic medicine represents a significant advancement in epilepsy management.
Development of objective seizure markers and biomarkers for neural excitability is crucial.
Future bioelectronic medicine may offer curative potential by remodeling neural networks.