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Epilepsy, seizure, neuromodulation

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https://www.readbyqxmd.com/read/30441025/long-term-in-vivo-performance-of-novel-ultrasound-powered-implantable-devices
#1
Chaoyi Kang, Ting Chia Chang, Jesse Vo, Jayant Charthad, Marcus Weber, Amin Arbabian, Srikanth Vasudevan
Neuromodulation devices have been approved for the treatment of epilepsy and seizures, with many other applications currently under research investigation. These devices rely on implanted battery powered pulse generators, that require replacement over time. Miniaturized ultrasound powered implantable devices have the potential to eliminate the need for batteries in neuromodulation devices. While these devices have been assessed in vitro, long-term in vivo assessment is required to determine device safety and performance...
July 2018: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/30355701/gauging-seizure-risk
#2
REVIEW
Maxime O Baud, Vikram R Rao
The current paradigm for treatment of epilepsy begins with trials of antiepileptic drugs, followed by evaluation for resective brain surgery in drug-resistant patients. If surgery is not possible or fails to control seizures, some patients benefit from implanted neurostimulation devices. In addition to their therapeutic benefit, some of these devices have diagnostic capability enabling recordings of brain activity with unprecedented chronicity. Two recent studies using different devices for chronic EEG (i.e...
October 24, 2018: Neurology
https://www.readbyqxmd.com/read/30349461/bioenergetic-mechanisms-of-seizure-control
#3
REVIEW
Richard Kovács, Zoltan Gerevich, Alon Friedman, Jakub Otáhal, Ofer Prager, Siegrun Gabriel, Nikolaus Berndt
Epilepsy is characterized by the regular occurrence of seizures, which follow a stereotypical sequence of alterations in the electroencephalogram. Seizures are typically a self limiting phenomenon, concluding finally in the cessation of hypersynchronous activity and followed by a state of decreased neuronal excitability which might underlie the cognitive and psychological symptoms the patients experience in the wake of seizures. Many efforts have been devoted to understand how seizures spontaneously stop in hope to exploit this knowledge in anticonvulsant or neuroprotective therapies...
2018: Frontiers in Cellular Neuroscience
https://www.readbyqxmd.com/read/30124015/-wavelet-entropy-analysis-for-ictal-electroencephalogram-signals-of-child-absence-epilepsy
#4
Meiyun Zhang, Chen Wang, Ying Zhang, Ying Chen, Bo Wu, Yuqin Zhang, Fenglou Wang
The integral and individual-scale wavelet entropy of electroencephalogram (EEG) were employed to investigate the information complexity in EEG and to explore the dynamic mechanism of child absence epilepsy (CAE). The digital EEG signals were collected from patients with CAE and normal controls. Time-frequency features were extracted by continuous wavelet transformation. Individual scale power spectrum characteristics were represented by wavelet-transform. The integral and individual-scale wavelet entropy of EEG were computed on the basis of individual scale power spectrum...
April 1, 2018: Sheng Wu Yi Xue Gong Cheng Xue za Zhi, Journal of Biomedical Engineering, Shengwu Yixue Gongchengxue Zazhi
https://www.readbyqxmd.com/read/30108472/expanding-brain-computer-interfaces-for-controlling-epilepsy-networks-novel-thalamic-responsive-neurostimulation-in-refractory-epilepsy
#5
Abhijeet Gummadavelli, Hitten P Zaveri, Dennis D Spencer, Jason L Gerrard
Seizures have traditionally been considered hypersynchronous excitatory events and epilepsy has been separated into focal and generalized epilepsy based largely on the spatial distribution of brain regions involved at seizure onset. Epilepsy, however, is increasingly recognized as a complex network disorder that may be distributed and dynamic. Responsive neurostimulation (RNS) is a recent technology that utilizes intracranial electroencephalography (EEG) to detect seizures and delivers stimulation to cortical and subcortical brain structures for seizure control...
2018: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/30064328/fast-gray-matter-acquisition-t1-inversion-recovery-mri-to-delineate-the-mammillothalamic-tract-for-preoperative-direct-targeting-of-the-anterior-nucleus-of-the-thalamus-for-deep-brain-stimulation-in-epilepsy
#6
Sanjeet S Grewal, Erik H Middlebrooks, Timothy J Kaufmann, Matthew Stead, Brian N Lundstrom, Gregory A Worrell, Chen Lin, Serhat Baydin, Jamie J Van Gompel
When medically intractable epilepsy is multifocal or focal but poorly localized, neuromodulation can be useful therapy. One such technique is deep brain stimulation (DBS) targeting the anterior nucleus of the thalamus (ANT). Unfortunately, the ANT is difficult to visualize in standard MRI sequences and its indirect targeting is difficult because of thalamic variability and atrophy in patients with epilepsy. The following study describes the novel use of the fast gray matter acquisition T1 inversion recovery (FGATIR) MRI sequence to delineate the mammillothalamic tract for direct targeting of the ANT through visualizing the termination of the mammillothalamic tract in the ANT...
August 2018: Neurosurgical Focus
https://www.readbyqxmd.com/read/29899691/brain-functional-connectivity-changes-after-transcranial-direct-current-stimulation-in-epileptic-patients
#7
Franca Tecchio, Carlo Cottone, Camillo Porcaro, Andrea Cancelli, Vincenzo Di Lazzaro, Giovanni Assenza
Focal epilepsy is a network pathology, where the brain connectivity of the epileptic focus (EF) influences seizure frequency and cortical dysfunction. Growing evidence supports a clinical efficacy of cathodal transcranial direct current stimulation (ctDCS) in drug-resistant epilepsy (DRE). ctDCS effects can be merely attributed to the inhibition of cortical excitability, which is abnormally increased in epilepsy, but its effect on brain network of DRE patients has never been reported. We aimed at exploring the hypothesis that functional connectivity (FC) changes may explain part of ctDCS clinical effects in DRE patients...
2018: Frontiers in Neural Circuits
https://www.readbyqxmd.com/read/29848786/relating-structural-and-functional-brainstem-connectivity-to-disease-measures-in-epilepsy
#8
Dario J Englot, Hernan F J Gonzalez, Bryson B Reynolds, Peter E Konrad, Monica L Jacobs, John C Gore, Bennett A Landman, Victoria L Morgan
OBJECTIVE: While epilepsy studies rarely examine brainstem, we sought to examine the hypothesis that temporal lobe epilepsy (TLE) leads to subcortical arousal center dysfunction, contributing to neocortical connectivity and neurocognitive disturbances. METHODS: In this case-control study of 26 adult patients with TLE and 26 controls, we used MRI to measure structural and functional connectivity of the cuneiform/subcuneiform nuclei (CSC), pedunculopontine nucleus, and ventral tegmental area...
July 3, 2018: Neurology
https://www.readbyqxmd.com/read/29803953/challenges-in-managing-epilepsy-associated-with-focal-cortical-dysplasia-in-children
#9
REVIEW
Lily C Wong-Kisiel, Thomas Blauwblomme, Mai-Lan Ho, Nathalie Boddaert, Joseph Parisi, Elaine Wirrell, Rima Nabbout
Focal cortical dysplasia (FCD) is the most common cause of intractable focal epilepsy in children, in whom seizures are most commonly pharmacoresistant from onset. This review summarizes the current understandings of the epidemiology, natural history, and the proposed mechanisms of epileptogenisis in FCD. Advances in neuroimaging techniques have enhanced the recognition of this pathology, which can be subtle. Illustrative neurophysiology and imaging examples are provided to help the clinicians identify diagnostic evidence of suspected FCD...
September 2018: Epilepsy Research
https://www.readbyqxmd.com/read/29748917/taurine-protects-from-pentylenetetrazole-induced-behavioral-and-neurochemical-changes-in-zebrafish
#10
Barbara D Fontana, Paola R Ziani, Julia Canzian, Nathana J Mezzomo, Talise E Müller, Matheus M Dos Santos, Vania L Loro, Nilda V Barbosa, Carlos F Mello, Denis B Rosemberg
Epilepsy is a common neurological disorder characterized by recurrent unprovoked seizures, which culminate in various neurobehavioral and neurochemical changes. Taurine (TAU) is an amino sulfonic acid which acts an endogenous inhibitory neuromodulator. Moreover, TAU displays intrinsic antioxidant activity, contributing to its beneficial actions in the CNS. Here, we evaluated whether TAU pretreatment protects from pentylenetetrazole (PTZ)-induced behavioral alterations and oxidative stress-related parameters in zebrafish brain tissue...
May 11, 2018: Molecular Neurobiology
https://www.readbyqxmd.com/read/29722352/epilepsy
#11
REVIEW
Orrin Devinsky, Annamaria Vezzani, Terence J O'Brien, Nathalie Jette, Ingrid E Scheffer, Marco de Curtis, Piero Perucca
Epilepsy affects all age groups and is one of the most common and most disabling neurological disorders. The accurate diagnosis of seizures is essential as some patients will be misdiagnosed with epilepsy, whereas others will receive an incorrect diagnosis. Indeed, errors in diagnosis are common, and many patients fail to receive the correct treatment, which often has severe consequences. Although many patients have seizure control using a single medication, others require multiple medications, resective surgery, neuromodulation devices or dietary therapies...
May 3, 2018: Nature Reviews. Disease Primers
https://www.readbyqxmd.com/read/29670050/epilepsy-and-neuromodulation-randomized-controlled-trials
#12
Churl-Su Kwon, Valeria Ripa, Omar Al-Awar, Fedor Panov, Saadi Ghatan, Nathalie Jetté
Neuromodulation is a treatment strategy that is increasingly being utilized in those suffering from drug-resistant epilepsy who are not appropriate for resective surgery. The number of double-blinded RCTs demonstrating the efficacy of neurostimulation in persons with epilepsy is increasing. Although reductions in seizure frequency is common in these trials, obtaining seizure freedom is rare. Invasive neuromodulation procedures (DBS, VNS, and RNS) have been approved as therapeutic measures. However, further investigations are necessary to delineate effective targeting, minimize side effects that are related to chronic implantation and to improve the cost effectiveness of these devices...
April 18, 2018: Brain Sciences
https://www.readbyqxmd.com/read/29608654/the-ventrolateral-medulla-and-medullary-raphe-in-sudden-unexpected-death-in-epilepsy
#13
Smriti Patodia, Alyma Somani, Megan O'Hare, Ranjana Venkateswaran, Joan Liu, Zuzanna Michalak, Matthew Ellis, Ingrid E Scheffer, Beate Diehl, Sanjay M Sisodiya, Maria Thom
Sudden unexpected death in epilepsy (SUDEP) is a leading cause of premature death in patients with epilepsy. One hypothesis proposes that sudden death is mediated by post-ictal central respiratory depression, which could relate to underlying pathology in key respiratory nuclei and/or their neuromodulators. Our aim was to investigate neuronal populations in the ventrolateral medulla (which includes the putative human pre-Bötzinger complex) and the medullary raphe. Forty brainstems were studied comprising four groups: 14 SUDEP, six epilepsy controls, seven Dravet syndrome cases and 13 non-epilepsy controls...
June 1, 2018: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/29588969/neurostimulation-as-a-promising-epilepsy-therapy
#14
REVIEW
Yicong Lin, Yuping Wang
The revolution in theory, swift technological developments, and invention of new devices have driven tremendous progress in neurostimulation as a third-line treatment for epilepsy. Over the past decades, neurostimulation took its place in the field of epilepsy as an advanced treatment technique and opened up a new world. Numerous animal studies have proven the physical efficacy of stimulation of the brain and peripheral nerves. Based on this optimistic fundamental research, new advanced techniques are being explored in clinical practice...
December 2017: Epilepsia Open
https://www.readbyqxmd.com/read/29515512/stimulation-induced-electrographic-seizures-in-deep-brain-stimulation-of-the-anterior-nucleus-of-the-thalamus-do-not-preclude-a-subsequent-favorable-treatment-response
#15
Tommi Nora, Hanna Heinonen, Mirja Tenhunen, Sirpa Rainesalo, Soila Järvenpää, Kai Lehtimäki, Jukka Peltola
Deep brain stimulation (DBS) of the anterior nucleus of the thalamus (ANT) is a method of neuromodulation used for refractory focal epilepsy. We report a patient suffering from drug-resistant epilepsy who developed novel visual symptoms and atypical seizures with the onset of ANT-DBS therapy. Rechallenge under video electroencephalography recording confirmed that lowering the stimulation voltage alleviated these symptoms. Subsequent stimulation with the initial voltage value did not cause the recurrence of either the visual symptoms or the new seizure type, and appeared to alleviate the patient's seizures in long-term follow-up...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29490324/fighting-fire-with-fire-surgical-options-for-patients-with-drug-resistant-epilepsy
#16
REVIEW
Alina D Bayer, Andrew S Blum, Wael F Asaad, Julie Roth, Steven A Toms, Gina M Deck
While antiepileptic drugs (AEDs) provide adequate seizure control for most patients with epilepsy, ~30% continue to have seizures despite treatment with two or more AEDs.1 In addition to direct harm from seizures, poor epilepsy control correlates with higher mortality, morbidity, 2, 3 and cost to the healthcare system.4 In the subset of patients with persistent seizures despite medical management, surgical intervention and neuromodulation may be more effective. Primary care physicians and general neurologists should be aware of non-AED treatment options that are standard of care for drug- resistant epilepsy (DRE)...
March 1, 2018: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/29357461/phase-amplitude-coupling-within-the-anterior-thalamic-nuclei-during-seizures
#17
George M Ibrahim, Simeon Wong, Benjamin R Morgan, Nir Lipsman, Aria Fallah, Alexander G Weil, Vibhor Krishna, Richard A Wennberg, Andres A Lozano
Cross-frequency phase-amplitude coupling (cfPAC) subserves an integral role in the hierarchical organization of interregional neuronal communication and is also expressed by epileptogenic cortex during seizures. Here, we sought to characterize patterns of cfPAC expression in the anterior thalamic nuclei during seizures by studying extra-operative recordings in patients implanted with deep brain stimulation electrodes for intractable epilepsy. Nine seizures from two patients were analyzed in the peri-ictal period...
April 1, 2018: Journal of Neurophysiology
https://www.readbyqxmd.com/read/29306976/deep-brain-stimulation-of-the-anterior-nucleus-of-the-thalamus-for-drug-resistant-epilepsy
#18
REVIEW
Tim A M Bouwens van der Vlis, Olaf E M G Schijns, Frédéric L W V J Schaper, Govert Hoogland, Pieter Kubben, Louis Wagner, Rob Rouhl, Yasin Temel, Linda Ackermans
Despite the use of first-choice anti-epileptic drugs and satisfactory seizure outcome rates after resective epilepsy surgery, a considerable percentage of patients do not become seizure free. ANT-DBS may provide for an alternative treatment option in these patients. This literature review discusses the rationale, mechanism of action, clinical efficacy, safety, and tolerability of ANT-DBS in drug-resistant epilepsy patients. A review using systematic methods of the available literature was performed using relevant databases including Medline, Embase, and the Cochrane Library pertaining to the different aspects ANT-DBS...
January 6, 2018: Neurosurgical Review
https://www.readbyqxmd.com/read/29129763/mammillothalamic-and-mammillotegmental-tracts-as-new-targets-for-dementia-and-epilepsy-treatment
#19
REVIEW
Naci Balak, Ece Balkuv, Ali Karadag, Recep Basaran, Huseyin Biceroglu, Buruç Erkan, Necmettin Tanriover
BACKGROUND: Recently, neuromodulation through deep brain stimulation (DBS) has appeared as a new surgical procedure in the treatment of some types of dementia and epilepsy. The mammillothalamic and mammillotegmental tracts are involved among the new targets. To our knowledge, a review article focused specifically on these mammillary body efferents is lacking in the medical literature. Their contribution to memory is, regrettably, often overlooked. METHODS: A review of the relevant literature was conducted...
February 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29029236/first-in-human-experience-with-complete-integration-of-neuromodulation-device-within-a-customized-cranial-implant
#20
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...
July 1, 2018: Operative Neurosurgery (Hagerstown, Md.)
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