Bioelectric; Neuromodulation; Epilepsy; DBS; High-frequency stimulation; Low frequency stimulation

Drug-resistant epilepsy affects a significant portion of epileptic patients, necessitating alternative treatment strategies beyond pharmacological interventions. Bioelectric medicine, employing techniques like vagus nerve stimulation, deep brain stimulation, and responsive neurostimulation, has emerged as a promising approach. This review comparatively analyzes the mechanisms and clinical outcomes of high-frequency stimulation and low-frequency stimulation in the context of epilepsy treatment. We delve into the synaptic plasticity, neuronal network modulation, and neurochemical alterations induced by these stimulation paradigms, highlighting their potential to disrupt pathological synchronization and reduce seizure frequency. Furthermore, we discuss the rationale for selecting specific stimulation frequencies and target brain regions, considering the heterogeneity of epilepsy syndromes. By synthesizing existing literature, this review aims to provide a comprehensive overview of bioelectric approaches in epilepsy, informing future research and clinical applications.