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https://www.readbyqxmd.com/read/29144716/mechanism-of-action-of-non-invasive-cervical-vagus-nerve-stimulation-for-the-treatment-of-primary-headaches
#1
Bruce Simon, Justyna Blake
Stimulation of the cervical vagus nerve with implanted vagus nerve stimulation (iVNS) has been used clinically for more than 20 years to treat patients with epilepsy. More recently, a non-invasive cervical vagus nerve stimulation (nVNS), gammaCore, was developed, which has been purported to also stimulate the vagus nerve without the cost and morbidity associated with an iVNS system. gammaCore has been used to acutely treat various types of primary headaches, including migraine and cluster headaches (CH), and for the prevention of episodic, chronic, and menstrual migraines and CH...
November 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29128586/contraception-pregnancy-and-peripartum-experiences-among-women-with-epilepsy-in-bhutan
#2
Sheliza Halani, Lhab Tshering, Esther Bui, Sarah J Clark, Sara J Grundy, Tandin Pem, Sonam Lhamo, Ugyen Dema, Damber K Nirola, Chencho Dorji, Farrah J Mateen
INTRODUCTION: Reports on the reproductive health of women with epilepsy (WWE) in low- and middle-income countries (LMICs) are limited. Bhutan is a lower income country with a high estimated prevalence of epilepsy and no out-of-pocket payment requirements for health visits or medications. METHODS: We developed a 10-category survey to interview WWE ages 20-59 years in the Kingdom of Bhutan to understand their contraceptive use and peripartum experiences. WWE were recruited from 2016-2017 from an existing epilepsy cohort and their reproductive health data were merged with epilepsy and socioeconomic data obtained from initial clinical evaluations performed between 2014 and 2016...
October 18, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/29096220/ear-eeg-detects-ictal-and-interictal-abnormalities-in-focal-and-generalized-epilepsy-a-comparison-with-scalp-eeg-monitoring
#3
I C Zibrandtsen, P Kidmose, C B Christensen, T W Kjaer
OBJECTIVE: Ear-EEG is recording of electroencephalography from a small device in the ear. This is the first study to compare ictal and interictal abnormalities recorded with ear-EEG and simultaneous scalp-EEG in an epilepsy monitoring unit. METHODS: We recorded and compared simultaneous ear-EEG and scalp-EEG from 15 patients with suspected temporal lobe epilepsy. EEGs were compared visually by independent neurophysiologists. Correlation and time-frequency analysis was used to quantify the similarity between ear and scalp electrodes...
October 12, 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/29071466/cardiovascular-autonomic-effects-of-vagus-nerve-stimulation
#4
REVIEW
Iñigo Garamendi-Ruiz, Juan Carlos Gómez-Esteban
The vagus nerve is responsible for the parasympathetic innervation of the major thoracic and abdominal organs. It also carries sensory afferent fibres from these viscera and reaches different brain structures. These connections have proven useful in the treatment of different diseases. Afferent stimulation of the left vagus nerve is used to treat epilepsy and major depression, and stimulation of the right vagus nerve is being tried for the treatment of heart failure. The device used for the therapy delivers intermittent stimuli...
October 25, 2017: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
https://www.readbyqxmd.com/read/29060794/modified-automatic-r-peak-detection-algorithm-for-patients-with-epilepsy-using-a-portable-electrocardiogram-recorder
#5
J Jeppesen, S Beniczky, A Fuglsang Frederiksen, P Sidenius, P Johansen
Earlier studies have shown that short term heart rate variability (HRV) analysis of ECG seems promising for detection of epileptic seizures. A precise and accurate automatic R-peak detection algorithm is a necessity in a real-time, continuous measurement of HRV, in a portable ECG device. We used the portable CE marked ePatch® heart monitor to record the ECG of 14 patients, who were enrolled in the videoEEG long term monitoring unit for clinical workup of epilepsy. Recordings of the first 7 patients were used as training set of data for the R-peak detection algorithm and the recordings of the last 7 patients (467...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29060344/low-latency-vlsi-architecture-for-neural-cross-frequency-coupling-analysis
#6
Gerard O'Leary, Taufik A Valiante, Roman Genov
Growing evidence suggests that cross-frequency coupling (CFC) is a key mechanism in neuronal computation, communication, and learning in the brain. Abnormal CFC has been implicated in pathological brain states such as epilepsy and Parkinson's disease. A reduction in excessive coupling has been shown in effective neuromodulation treatments, suggesting that CFC may be a useful feedback measure in closed-loop neural stimulation devices. However, processing latency limits the responsiveness of such systems. A VLSI architecture is presented which implements three selectable measures of CFC to enable the application specific trade-off between low-latency and high-accuracy processing...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29059865/design-of-focal-brain-cooling-system-for-suppressing-epileptic-seizures
#7
Kei Hata, Koichi Fujiwara, Manabu Kano, Takao Inoue, Sadahiro Nomura, Hirochika Imoto, Michiyasu Suzuki
Epilepsy is a group of diseases caused by excessive neuronal activities, and one-quarter of the patients do not become seizure-free by the existing treatments. The potential treatments include focal brain cooling, which aims to cool the region where the excessive neuronal activities begin. We are developing a focal brain cooling system. The system delivers cold saline to a cranially implanted cooling device. The outflow is cooled by a Peltier device and pumped for circulation. The Peltier device and the pump are activated only when a seizure is predicted...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29059838/a-low-power-flash-fpga-based-brain-implant-micro-system-of-pid-control
#8
Lijuan Xia, Nabeel Fattah, Ahmed Soltan, Andrew Jackson, Graeme Chester, Patrick Degenaar
In this paper, we demonstrate that a low power flash FPGA based micro-system can provide a low power programmable interface for closed-loop brain implant inter- faces. The proposed micro-system receives recording local field potential (LFP) signals from an implanted probe, performs closed-loop control using a first order control system, then converts the signal into an optogenetic control stimulus pattern. Stimulus can be implemented through optoelectronic probes. The long term target is for both fundamental neuroscience applications and for clinical use in treating epilepsy...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29029236/first-in-human-experience-with-complete-integration-of-neuromodulation-device-within-a-customized-cranial-implant
#9
Chad R Gordon, Gabriel F Santiago, Judy Huang, Gregory K Bergey, Shuya Liu, Mehran Armand, Henry Brem, William S Anderson
BACKGROUND: Neuromodulation devices have the potential to transform modern day treatments for patients with medicine-resistant neurological disease. For instance, the NeuroPace System (NeuroPace Inc, Mountain View, California) is a Food and Drug Administration (FDA)-approved device developed for closed-loop direct brain neurostimulation in the setting of drug-resistant focal epilepsy. However, current methods require placement either above or below the skull in nonanatomic locations. This type of positioning has several drawbacks including visible deformities and scalp pressure from underneath leading to eventual wound healing difficulties, micromotion of hardware with infection, and extrusion leading to premature explantation...
October 6, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29027928/automated-epileptic-seizure-detection-based-on-wearable-ecg-and-ppg-in-a-hospital-environment
#10
Kaat Vandecasteele, Thomas De Cooman, Ying Gu, Evy Cleeren, Kasper Claes, Wim Van Paesschen, Sabine Van Huffel, Borbála Hunyadi
Electrocardiography has added value to automatically detect seizures in temporal lobe epilepsy (TLE) patients. The wired hospital system is not suited for a long-term seizure detection system at home. To address this need, the performance of two wearable devices, based on electrocardiography (ECG) and photoplethysmography (PPG), are compared with hospital ECG using an existing seizure detection algorithm. This algorithm classifies the seizures on the basis of heart rate features, extracted from the heart rate increase...
October 13, 2017: Sensors
https://www.readbyqxmd.com/read/29018634/detection-of-paroxysms-in-long-term-single-channel-eeg-monitoring-of-patients-with-typical-absence-seizures
#11
Troels W Kjaer, Helge B D Sorensen, Sabine Groenborg, Charlotte R Pedersen, Jonas Duun-Henriksen
Absence seizures are associated with generalized 2.5-5 Hz spike-wave discharges in the electroencephalogram (EEG). Rarely are patients, parents, or physicians aware of the duration or incidence of seizures. Six patients were monitored with a portable EEG-device over four times 24 h to evaluate how easily outpatients are monitored and how well an automatic seizure detection algorithm can identify the absences. Based on patient-specific modeling, we achieved a sensitivity of 98.4% with only 0.23 false detections per hour...
2017: IEEE Journal of Translational Engineering in Health and Medicine
https://www.readbyqxmd.com/read/28994627/mybrain-a-novel-eeg-embedded-system-for-epilepsy-monitoring
#12
Francisco Pinho, João Cerqueira, José Correia, Nuno Sousa, Nuno Dias
The World Health Organisation has pointed that a successful health care delivery, requires effective medical devices as tools for prevention, diagnosis, treatment and rehabilitation. Several studies have concluded that longer monitoring periods and outpatient settings might increase diagnosis accuracy and success rate of treatment selection. The long-term monitoring of epileptic patients through electroencephalography (EEG) has been considered a powerful tool to improve the diagnosis, disease classification, and treatment of patients with such condition...
October 10, 2017: Journal of Medical Engineering & Technology
https://www.readbyqxmd.com/read/28983274/ranking-the-leading-risk-factors-for-sudden-unexpected-death-in-epilepsy
#13
REVIEW
Christopher M DeGiorgio, Daniela Markovic, Rajarshi Mazumder, Brian D Moseley
BACKGROUND: Sudden unexpected death in epilepsy (SUDEP) is rare in well-controlled epilepsy. However, SUDEP is a common cause of death in drug-resistant epilepsy. Over the last 30 years, multiple cohort and population studies have identified clinical risk factors associated with an increased risk for SUDEP. OBJECTIVE: To identify and rank the leading SUDEP risk factors from major cohort and population-based studies. The incidence of SUDEP is also evaluated in special clinical situations, including antiepileptic drug treatment, epilepsy surgery, devices, and assignment to placebo in clinical trials...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28981509/differential-temperature-sensitivity-of-synaptic-and-firing-processes-in-a-neural-mass-model-of-epileptic-discharges-explains-heterogeneous-response-of-experimental-epilepsy-to-focal-brain-cooling
#14
Jaymar Soriano, Takatomi Kubo, Takao Inoue, Hiroyuki Kida, Toshitaka Yamakawa, Michiyasu Suzuki, Kazushi Ikeda
Experiments with drug-induced epilepsy in rat brains and epileptic human brain region reveal that focal cooling can suppress epileptic discharges without affecting the brain's normal neurological function. Findings suggest a viable treatment for intractable epilepsy cases via an implantable cooling device. However, precise mechanisms by which cooling suppresses epileptic discharges are still not clearly understood. Cooling experiments in vitro presented evidence of reduction in neurotransmitter release from presynaptic terminals and loss of dendritic spines at post-synaptic terminals offering a possible synaptic mechanism...
October 2017: PLoS Computational Biology
https://www.readbyqxmd.com/read/28980702/detection-of-generalized-tonic-clonic-seizures-using-surface-electromyographic-monitoring
#15
MULTICENTER STUDY
Jonathan J Halford, Michael R Sperling, Dileep R Nair, Dennis J Dlugos, William O Tatum, Jay Harvey, Jacqueline A French, John R Pollard, Edward Faught, Katherine H Noe, Thomas R Henry, Gina M Jetter, Octavian V Lie, Lola C Morgan, Michael R Girouard, Damon P Cardenas, Luke E Whitmire, Jose E Cavazos
OBJECTIVE: A prospective multicenter phase III trial was undertaken to evaluate the performance and tolerability in the epilepsy monitoring unit (EMU) of an investigational wearable surface electromyographic (sEMG) monitoring system for the detection of generalized tonic-clonic seizures (GTCSs). METHODS: One hundred ninety-nine patients with a history of GTCSs who were admitted to the EMU in 11 level IV epilepsy centers for clinically indicated video-electroencephalographic monitoring also received sEMG monitoring with a wearable device that was worn on the arm over the biceps muscle...
November 2017: Epilepsia
https://www.readbyqxmd.com/read/28980315/multicenter-clinical-assessment-of-improved-wearable-multimodal-convulsive-seizure-detectors
#16
MULTICENTER STUDY
Francesco Onorati, Giulia Regalia, Chiara Caborni, Matteo Migliorini, Daniel Bender, Ming-Zher Poh, Cherise Frazier, Eliana Kovitch Thropp, Elizabeth D Mynatt, Jonathan Bidwell, Roberto Mai, W Curt LaFrance, Andrew S Blum, Daniel Friedman, Tobias Loddenkemper, Fatemeh Mohammadpour-Touserkani, Claus Reinsberger, Simone Tognetti, Rosalind W Picard
OBJECTIVE: New devices are needed for monitoring seizures, especially those associated with sudden unexpected death in epilepsy (SUDEP). They must be unobtrusive and automated, and provide false alarm rates (FARs) bearable in everyday life. This study quantifies the performance of new multimodal wrist-worn convulsive seizure detectors. METHODS: Hand-annotated video-electroencephalographic seizure events were collected from 69 patients at six clinical sites. Three different wristbands were used to record electrodermal activity (EDA) and accelerometer (ACM) signals, obtaining 5,928 h of data, including 55 convulsive epileptic seizures (six focal tonic-clonic seizures and 49 focal to bilateral tonic-clonic seizures) from 22 patients...
November 2017: Epilepsia
https://www.readbyqxmd.com/read/28966573/a-chronically-implantable-bidirectional-neural-interface-for-non-human-primates
#17
Misako Komatsu, Eriko Sugano, Hiroshi Tomita, Naotaka Fujii
Optogenetics has potential applications in the study of epilepsy and neuroprostheses, and for studies on neural circuit dynamics. However, to achieve translation to clinical usage, optogenetic interfaces that are capable of chronic stimulation and monitoring with minimal brain trauma are required. We aimed to develop a chronically implantable device for photostimulation of the brain of non-human primates. We used a micro-light-emitting diode (LED) array with a flexible polyimide film. The array was combined with a whole-cortex electrocorticographic (ECoG) electrode array for simultaneous photostimulation and recording...
2017: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/28951181/clinical-accuracy-of-customized-stereotactic-fixtures-for-stereo-eeg
#18
Hong Yu, Constantin Pistol, Ronald Franklin, Andrei Barborica
BACKGROUND: Stereo-EEG is a diagnostic methodology involving 3D exploration of brain structures using depth electrodes for locating epileptogenic foci in patients with drug-resistant epilepsy. A variety of frame-based, frameless, and robotic stereotactic systems have been designed for the accurate placement of depth electrodes. OBJECTIVES: Using the FHC microTargeting™ platform as a model, we introduce a fully customized design that has all the constructive elements positioned by a computer algorithm, according to the planned trajectories, anchoring points, and anatomical constraints...
September 22, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28931943/vagus-nerve-stimulation-paired-with-tones-for-the-treatment-of-tinnitus-a-prospective-randomized-double-blind-controlled-pilot-study-in-humans
#19
Richard Tyler, Anthony Cacace, Christina Stocking, Brent Tarver, Navzer Engineer, Jeffrey Martin, Aniruddha Deshpande, Nancy Stecker, Melissa Pereira, Michael Kilgard, Chester Burress, David Pierce, Robert Rennaker, Sven Vanneste
The aim of the pilot study was to evaluate the effect of Vagus Nerve Stimulation (VNS) paired with sounds in chronic tinnitus patients. All participants were implanted and randomized to a paired VNS (n = 16) or control (n = 14) group. After 6 weeks of home therapy, all participants received paired VNS. The device was used on 96% of days with good compliance. After 6 weeks, the paired VNS group improved on the Tinnitus Handicap Inventory (THI) (p = 0.0012) compared to controls (p = 0.1561). The between-group difference was 10...
September 20, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28927833/modulation-of-hippocampal-activity-with-fornix-deep-brain-stimulation
#20
Paul H Stypulkowski, Scott R Stanslaski, Jonathon E Giftakis
BACKGROUND: Deep Brain Stimulation (DBS) within the Papez circuit is under investigation as a treatment for epilepsy and Alzheimer's disease. We previously reported the effects of stimulation at nodes within this network (anterior thalamic nucleus and hippocampus) on hippocampal activity in a large animal model, using a chronic implantable, clinical-grade system that permits concurrent stimulation and recording. OBJECTIVE: In this study we extended earlier work to compare the effects of fornix DBS on evoked potentials (EPs) and local field potential (LFP) activity within the hippocampus, and to assess closed-loop stimulation...
September 6, 2017: Brain Stimulation
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