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Personalizing Responsive Neurostimulation for Epilepsy.

Vikram R Rao1

  • 1Department of Neurology and Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, U.S.A .

Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society
|June 24, 2025
PubMed
Summary
This summary is machine-generated.

Responsive neurostimulation (RNS) offers gradual seizure reduction for epilepsy but lacks personalized optimization. Future advances in AI and neuroimaging promise more tailored and effective RNS therapy for patients.

Keywords:
Brain networksClosed-loopDrug-resistant epilepsyNeuromodulationRNSSeizure

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Area of Science:

  • Neurology
  • Biomedical Engineering
  • Artificial Intelligence

Background:

  • Responsive neurostimulation (RNS) is a closed-loop device for drug-resistant focal epilepsy.
  • RNS therapy offers gradual seizure reduction and intracranial recordings but has limitations.
  • Current RNS use is largely empiric due to poorly understood antiseizure mechanisms.

Purpose of the Study:

  • To review progress toward rational, personalized neurostimulation.
  • To highlight emerging paradigm shifts in RNS therapy.
  • To explore novel approaches for optimizing RNS treatment.

Main Methods:

  • Review of recent advances in neuroimaging, neurophysiology, AI, and engineering.
  • Focus on patient selection, brain network topology, state-dependent effects, and stimulation parameter optimization.
  • Analysis of the 'who, where, when, and how' of RNS therapy.

Main Results:

  • Advances in technology are making personalized neurostimulation a reality.
  • Novel approaches are emerging for patient selection and targeting brain regions.
  • Optimization of stimulation parameters and understanding state-dependent effects are key.

Conclusions:

  • Responsive neurostimulation (RNS) has significant potential beyond current applications.
  • Personalized approaches informed by AI and advanced imaging will enhance RNS effectiveness.
  • A new era of more personalized and effective RNS therapy is anticipated.