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Epilepsy, seizure, neuromodulation

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https://www.readbyqxmd.com/read/29899691/brain-functional-connectivity-changes-after-transcranial-direct-current-stimulation-in-epileptic-patients
#1
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
#2
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
#3
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...
May 14, 2018: Epilepsy Research
https://www.readbyqxmd.com/read/29748917/taurine-protects-from-pentylenetetrazole-induced-behavioral-and-neurochemical-changes-in-zebrafish
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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/29023305/insights-into-the-therapeutic-effect-of-responsive-neurostimulation-assessed-with-scalp-eeg-recording-a-case-report
#15
Maria Jose Bruzzone, Naoum Issa, Sandra Rose, Peter Warnke, Vernon L Towle, James X Tao, Shasha Wu
The responsive neurostimulation system (RNS) is the first closed-loop neurostimulator approved as an adjunctive treatment for adults with medically refractory focal epilepsy from no more than two seizure foci. In addition to its therapeutic effect, it provides chronic intracranial EEG recordings, with limited storage capacity. Long-term monitoring with scalp EEG recordings can provide additional information regarding seizure patterns, the efficacy of RNS stimulation in aborting individual seizures, and the net effect of RNS on seizure control...
October 10, 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/28766041/the-role-of-the-basal-ganglia-in-the-control-of-seizure
#16
REVIEW
J Vuong, Annaelle Devergnas
Epilepsy is a network disorder and each type of seizure involves distinct cortical and subcortical network, differently implicated in the control and propagation of the ictal activity. The role of the basal ganglia has been revealed in several cases of focal and generalized seizures. Here, we review the data that show the implication of the basal ganglia in absence, temporal lobe, and neocortical seizures in animal models (rodent, cat, and non-human primate) and in human. Based on these results and the advancement of deep brain stimulation for Parkinson's disease, basal ganglia neuromodulation has been tested with some success that can be equally seen as promising or disappointing...
March 2018: Journal of Neural Transmission
https://www.readbyqxmd.com/read/28758271/visually-stressful-striped-patterns-alter-human-visual-cortical-functional-connectivity
#17
Jie Huang, David C Zhu
Visually stressful striped patterns with a spatial frequency (SF) of around 3 cycles per degree (cpd) can induce perceptual illusions/distortions and visual discomfort in most people, headaches in patients with migraine, and seizures in patients with photosensitive epilepsy. Patterns with SF ∼0.3 cpd have no such effects and are not uncomfortable to look at (non-stressful). The effects of the striped patterns on visual cortical activation have been investigated, but their effects on the visual cortical network remain to be studied...
November 2017: Human Brain Mapping
https://www.readbyqxmd.com/read/28587936/intra-hippocampal-microinjection-of-oxytocin-produced-antiepileptic-effect-on-the-pentylenetetrazol-induced-epilepsy-in-rats
#18
Amir Erfanparast, Esmaeal Tamaddonfard, Farzin Henareh-Chareh
BACKGROUND: In addition to its role as a circulating hormone, oxytocin can also act as a neurotransmitter and a neuromodulator within the brain. In this study, we investigated the intra-hippocampal effect of oxytocin on an experimental seizure model induced by pentylenetetrazole (PTZ) in rats. We also used atosiban (oxytocin antagonist), diazepam and flumazenil (gamma-aminobutyric acid or GABA-benzodiazepine receptor agonist and antagonist, respectively) to clarify the involved mechanism...
August 2017: Pharmacological Reports: PR
https://www.readbyqxmd.com/read/28490738/model-guided-control-of-hippocampal-discharges-by-local-direct-current-stimulation
#19
Faten Mina, Julien Modolo, Fanny Recher, Gabriel Dieuset, Arnaud Biraben, Pascal Benquet, Fabrice Wendling
Neurostimulation is an emerging treatment for drug-resistant epilepsies when surgery is contraindicated. Recent clinical results demonstrate significant seizure frequency reduction in epileptic patients, however the mechanisms underlying this therapeutic effect are largely unknown. This study aimed at gaining insights into local direct current stimulation (LDCS) effects on hyperexcitable tissue, by i) analyzing the impact of electrical currents locally applied on epileptogenic brain regions, and ii) characterizing currents achieving an "anti-epileptic" effect (excitability reduction)...
May 10, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28269703/cross-entropy-optimization-for-neuromodulation
#20
Harleen K Brar, Yunpeng Pan, Babak Mahmoudi, Evangelos A Theodorou
This study presents a reinforcement learning approach for the optimization of the proportional-integral gains of the feedback controller represented in a computational model of epilepsy. The chaotic oscillator model provides a feedback control systems view of the dynamics of an epileptic brain with an internal feedback controller representative of the natural seizure suppression mechanism within the brain circuitry. Normal and pathological brain activity is simulated in this model by adjusting the feedback gain values of the internal controller...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
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