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https://www.readbyqxmd.com/read/28523978/closed-loop-neuromodulation-systems-next-generation-treatments-for-psychiatric-illness
#1
Meng-Chen Lo, Alik S Widge
Despite deep brain stimulation's positive early results in psychiatric disorders, well-designed clinical trials have yielded inconsistent clinical outcomes. One path to more reliable benefit is closed-loop therapy: stimulation that is automatically adjusted by a device or algorithm in response to changes in the patient's electrical brain activity. These interventions may provide more precise and patient-specific treatments. This article first introduces the available closed-loop neuromodulation platforms, which have shown clinical efficacy in epilepsy and strong early results in movement disorders...
April 2017: International Review of Psychiatry
https://www.readbyqxmd.com/read/28488608/epilepsy-surgery-in-children
#2
REVIEW
Sita Jayalakshmi, Sudhindra Vooturi, Swapan Gupta, Manas Panigrahi
Approximately 60% of all patients with epilepsy suffer from focal epilepsy syndromes. In approximately 15% of these patients, the seizures are not adequately controlled with anticonvulsive drugs, and such patients are potential candidates for surgical treatment and majority are children. Epilepsy surgery in children, who have been carefully chosen, can result in either seizure freedom or a marked (>90%) reduction in seizures in approximately two-third of children with intractable seizures. In the multimodality presurgical evaluation approach, sufficient concordance should be established among various independent investigations, thus identifying the location and extent of the epileptogenic zone with a high degree of confidence...
May 2017: Neurology India
https://www.readbyqxmd.com/read/28486925/the-mutual-interaction-between-sleep-and-epilepsy-on-the-neurobiological-basis-and-therapy
#3
Yi-Qun Wang, Meng-Qi Zhang, Rui Li, Wei-Min Qu, Zhi-Li Huang
Sleep and epilepsy are mutually related in a complex, bidirectional manner. However, our understanding of this relationship remains unclear. In this paper, we address the issues involved in these phenomena and also discuss the various therapies used to modify them. The literatures of the neurobiological basis of the interactions between sleep and epilepsy indicate that non-rapid eye movement sleep and idiopathic generalized epilepsy share the same thalamocortical networks. Neuromodulators-such as adenosine, melatonin, prostaglandin D2, serotonin, and histamine-promote wakefulness and are considered to have antiepilepsy effects; antiepileptic drugs, in turn, also have effects on sleep...
May 8, 2017: Current Neuropharmacology
https://www.readbyqxmd.com/read/28469569/eliminating-absence-seizures-through-the-deep-brain-stimulation-to-thalamus-reticular-nucleus
#4
Zhihui Wang, Qingyun Wang
Deep brain stimulation (DBS) can play a crucial role in the modulation of absence seizures, yet relevant biophysical mechanisms are not completely established. In this paper, on the basis of a biophysical mean-field model, we investigate a typical absence epilepsy activity by introducing slow kinetics of GABAB receptors on thalamus reticular nucleus (TRN). We find that the region of spike and slow-wave discharges (SWDs) can be reduced greatly when we add the DBS to TRN. Furthermore, we systematically explore how the corresponding stimulation parameters including frequency, amplitude and positive input duration suppress the SWDs under certain conditions...
2017: Frontiers in Computational Neuroscience
https://www.readbyqxmd.com/read/28463617/robot-assisted-procedures-in-pediatric-neurosurgery
#5
Alessandro De Benedictis, Andrea Trezza, Andrea Carai, Elisabetta Genovese, Emidio Procaccini, Raffaella Messina, Franco Randi, Silvia Cossu, Giacomo Esposito, Paolo Palma, Paolina Amante, Michele Rizzi, Carlo Efisio Marras
OBJECTIVE During the last 3 decades, robotic technology has rapidly spread across several surgical fields due to the continuous evolution of its versatility, stability, dexterity, and haptic properties. Neurosurgery pioneered the development of robotics, with the aim of improving the quality of several procedures requiring a high degree of accuracy and safety. Moreover, robot-guided approaches are of special interest in pediatric patients, who often have altered anatomy and challenging relationships between the diseased and eloquent structures...
May 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28386921/deep-brain-stimulation-targeting-in-refractory-epilepsy
#6
Arthur Cukiert, Kai Lehtimäki
Deep brain stimulation has been used in increasing frequency to treat refractory epilepsy. Different targets have been tried, and different epileptic syndromes have been addressed in different ways. We describe the current targeting techniques for the structures presently most often implanted, namely the anterior nucleus of the thalamus, the centromedian nucleus of the thalamus, and the hippocampus.
April 2017: Epilepsia
https://www.readbyqxmd.com/read/28357411/gnao1-encephalopathy-broadening-the-phenotype-and-evaluating-treatment-and-outcome
#7
Federica Rachele Danti, Serena Galosi, Marta Romani, Martino Montomoli, Keren J Carss, F Lucy Raymond, Elena Parrini, Claudia Bianchini, Tony McShane, Russell C Dale, Shekeeb S Mohammad, Ubaid Shah, Neil Mahant, Joanne Ng, Amy McTague, Rajib Samanta, Gayatri Vadlamani, Enza Maria Valente, Vincenzo Leuzzi, Manju A Kurian, Renzo Guerrini
OBJECTIVE: To describe better the motor phenotype, molecular genetic features, and clinical course of GNAO1-related disease. METHODS: We reviewed clinical information, video recordings, and neuroimaging of a newly identified cohort of 7 patients with de novo missense and splice site GNAO1 mutations, detected by next-generation sequencing techniques. RESULTS: Patients first presented in early childhood (median age of presentation 10 months, range 0-48 months), with a wide range of clinical symptoms ranging from severe motor and cognitive impairment with marked choreoathetosis, self-injurious behavior, and epileptic encephalopathy to a milder phenotype, featuring moderate developmental delay associated with complex stereotypies, mainly facial dyskinesia and mild epilepsy...
April 2017: Neurology. Genetics
https://www.readbyqxmd.com/read/28285213/remote-modulation-of-network-excitability-during-deep-brain-stimulation-for-epilepsy
#8
REVIEW
Dong-Hong Li, Xiao-Feng Yang
Deep brain stimulation (DBS) has become a well-accepted medical therapy in the treatment of movement disorders such as Parkinson's disease, and is currently under investigation as a treatment for other disorders, including epilepsy. Although DBS is widely used, its therapeutic mechanisms remain poorly understood. Recent research shows that seizures are network-level phenomena, but the incomplete knowledge of neural circuit function has left a gap in our understanding of how disruption at a molecular or cellular level generates epilepsy...
April 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28269577/sinusoidal-stimulation-trains-suppress-epileptiform-spikes-induced-by-4-ap-in-the-rat-hippocampal-ca1-region-in-vivo
#9
Zheshan Guo, Zhouyan Feng, Ying Yu, Wenjie Zhou, Zhaoxiang Wang, Xuefeng Wei
Deep brain stimulation (DBS) shows promises in the treatment of refractory epilepsy. Due to the complex causes of epilepsy, the mechanisms of DBS are still unclear. Depolarization block caused by the persistent excitation of neurons may be one of the possible mechanisms. To test the hypothesis, 4-aminopyridine (4-AP) was injected in rat hippocampal CA1 region in-vivo to induce epileptiform activity. Sinusoidal stimulation trains were applied to the afferent pathway (Schaffer collaterals) of CA1 region to suppress the epileptiform spikes...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28269576/detection-of-single-unit-spikes-during-orthodromic-high-frequency-stimulation-in-rat-hippocampus
#10
Zhaoxiang Wang, Zhouyan Feng, Ying Yu, Yufang Zhu, Zheshan Guo
Deep brain stimulation (DBS) has been used as a treatment of brain diseases such as Parkinson's disease and is a promising therapy for epilepsy. But the mechanisms of high frequency stimulation (HFS) used by DBS are still uncertain. In order to investigate the changes of action penitential firings of individual neurons (single unit activity, SUA) during the period of HFS, a new algorithm based on window detection was designed to detect spikes in broadband-frequency recording signals. The results show that orthodromic-HFS (O-HFS) could excite the neurons in CA1 regions, and the firing rate of interneurons and pyramidal neurons increased significantly...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28251589/neurostimulation-devices-used-in-treatment-of-epilepsy
#11
REVIEW
Evren Burakgazi Dalkilic
Epilepsy is a chronic neurological disorder frequently requiring lifelong treatment. In 70% of epilepsy patients, seizures are well controlled by antiepileptic medications. About 30% of epilepsy patients remain refractory to medical treatments and may need surgical interventions for better seizure control. Unfortunately and not infrequently, surgical intervention is not feasible due to various reasons such as multiple seizure foci, not resectable focus because of eloquent cortex location, or inability to tolerate surgery due to ongoing concomitant medical conditions...
February 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28227832/sinusoidal-stimulation-trains-suppress-epileptiform-spikes-induced-by-4-ap-in-the-rat-hippocampal-ca1-region-in-vivo
#12
Zheshan Guo, Zhouyan Feng, Ying Yu, Wenjie Zhou, Zhaoxiang Wang, Xuefeng Wei, Zheshan Guo, Zhouyan Feng, Ying Yu, Wenjie Zhou, Zhaoxiang Wang, Xuefeng Wei, Ying Yu, Zhouyan Feng, Xuefeng Wei, Zhaoxiang Wang, Zheshan Guo, Wenjie Zhou
Deep brain stimulation (DBS) shows promises in the treatment of refractory epilepsy. Due to the complex causes of epilepsy, the mechanisms of DBS are still unclear. Depolarization block caused by the persistent excitation of neurons may be one of the possible mechanisms. To test the hypothesis, 4-aminopyridine (4-AP) was injected in rat hippocampal CA1 region in-vivo to induce epileptiform activity. Sinusoidal stimulation trains were applied to the afferent pathway (Schaffer collaterals) of CA1 region to suppress the epileptiform spikes...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227831/detection-of-single-unit-spikes-during-orthodromic-high-frequency-stimulation-in-rat-hippocampus
#13
Zhaoxiang Wang, Zhouyan Feng, Ying Yu, Yufang Zhu, Zheshan Guo, Zhaoxiang Wang, Zhouyan Feng, Ying Yu, Yufang Zhu, Zheshan Guo, Yufang Zhu, Ying Yu, Zhouyan Feng, Zhaoxiang Wang, Zheshan Guo
Deep brain stimulation (DBS) has been used as a treatment of brain diseases such as Parkinson's disease and is a promising therapy for epilepsy. But the mechanisms of high frequency stimulation (HFS) used by DBS are still uncertain. In order to investigate the changes of action penitential firings of individual neurons (single unit activity, SUA) during the period of HFS, a new algorithm based on window detection was designed to detect spikes in broadband-frequency recording signals. The results show that orthodromic-HFS (O-HFS) could excite the neurons in CA1 regions, and the firing rate of interneurons and pyramidal neurons increased significantly...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28185967/intraoperative-computed-tomography-and-nexframe-guided-placement-of-bilateral-hippocampal-based-responsive-neurostimulation-technical-note
#14
Kunal Gupta, Jeffrey S Raskin, Ahmed M Raslan
INTRODUCTION: Surgical resection of a lesion that correlates with seizure onset in patients with epilepsy can dramatically improve seizure burden and quality of life. For bilateral hippocampal lesions, bilateral resection comes with a risk of severe cognitive deficits. Responsive neurostimulation (RNS) devices offer a new modality to treat multifocal lesions in a reversible manner including bilateral hippocampal stimulation. We describe technical aspects of Nexframe-assisted placement of bilateral NeuroPace mesial temporal electrodes and case examples...
May 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28061418/memory-and-mood-outcomes-after-anterior-thalamic-stimulation-for-refractory-partial-epilepsy
#15
Alexander I Tröster, Kimford J Meador, Christopher P Irwin, Robert S Fisher
PURPOSE: Bilateral deep brain stimulation (DBS) of the anterior nucleus of the thalamus (ANT) reduces seizures and is relatively safe but may be accompanied by complaints of memory problems and depression. This study examined incidence of memory and depression adverse events (AE) in the SANTE study blinded phase and their relationship to objective neurobehavioral measures, baseline characteristics, quality of life and long-term neurobehavioral outcome. METHOD: The neurobehavioral AE and neuropsychological data from a previously reported prospective randomized trial (SANTE) were analyzed...
February 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28030998/the-role-of-thalamus-versus-cortex-in-epilepsy-evidence-from-human-ictal-centromedian-recordings-in-patients-assessed-for-deep-brain-stimulation
#16
David Martín-López, Diego Jiménez-Jiménez, Lidia Cabañés-Martínez, Richard P Selway, Antonio Valentín, Gonzalo Alarcón
BACKGROUND: The onset of generalized seizures is a long debated subject in epilepsy. The relative roles of cortex and thalamus in initiating and maintaining the different seizure types are unclear. OBJECTIVE: The purpose of the study is to estimate whether the cortex or the centromedian thalamic nucleus is leading in initiating and maintaining seizures in humans. METHODS: We report human ictal recordings with simultaneous thalamic and cortical electrodes from three patients without anesthesia being assessed for deep brain stimulation (DBS)...
October 24, 2016: International Journal of Neural Systems
https://www.readbyqxmd.com/read/28027070/innovations-in-functional-neurosurgery-and-anesthetic-implications
#17
Lauren K Dunn, Marcel E Durieux, W Jeffrey Elias, Edward C Nemergut, Bhiken I Naik
Functional neurosurgery has undergone rapid growth over the last few years fueled by advances in imaging technology and novel treatment modalities. These advances have led to new surgical treatments using minimally invasive and precise techniques for conditions such as Parkinson's disease, essential tremor, epilepsy, and psychiatric disorders. Understanding the goals and technological issues of these procedures is imperative for the anesthesiologist to ensure safe management of patients presenting for functional neurosurgical procedures...
December 23, 2016: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/27992003/neuromodulation-in-refractory-epilepsy-brazilian-specialists-consensus
#18
Vera Cristina Terra, Isabella D'Andrea-Meira, Ricardo Amorim, Francisco Arruda, Andrea Julião de Oliveira, Luciano De Paola, Adélia Maria de Miranda Henriques-Souza
Epilepsy is a potentially devastating brain disorder characterized by a predisposition to spontaneous epileptic seizures. In patients with medically refractory epilepsy, new non-pharmacological therapeutic approaches may be considered. In this scenario, palliative surgery such as vagus nerve stimulation (VNS) or deep brain stimulation (DBS) may be indicated in a subset of patients. In this paper we make recommendations for the use of VNS and DBS in patients in Brazil with refractory epilepsy.
December 2016: Arquivos de Neuro-psiquiatria
https://www.readbyqxmd.com/read/27965181/stimulation-of-the-bilateral-anterior-nuclei-of-the-thalamus-in-the-treatment-of-refractory-epilepsy-two-cases-of-subcortical-band-heterotopia
#19
Ana Franco, José Pimentel, Alexandre Rainha Campos, Carlos Morgado, Sara Pinelo, António Gonçalves Ferreira, Carla Bentes
Subcortical band heterotopia is a neuronal migration disorder that may cause refractory epilepsy. In these patients, resective surgery has yielded inadequate results. Deep brain stimulation of the anterior nuclei of the thalamus has been used for the treatment of refractory epilepsy with good results. We describe the first two patients with subcortical band heterotopia who were submitted to deep brain stimulation of the anterior nuclei of the thalamus, with evaluation of seizure outcome after 12 and 18 months of follow-up...
December 1, 2016: Epileptic Disorders: International Epilepsy Journal with Videotape
https://www.readbyqxmd.com/read/27846633/variations-in-thalamic-anatomy-affect-targeting-in-deep-brain-stimulation-for-epilepsy
#20
Chengyuan Wu, Pierre-François D'Haese, Srivatsan Pallavaram, Benoit M Dawant, Peter Konrad, Ashwini D Sharan
BACKGROUND: Thalamic size and shape vary significantly across patients - with changes specific to the anterior thalamus occurring with age and in the setting of chronic epilepsy. Such ambiguity raises concerns regarding electrode position and potential implications for seizure outcomes. METHODS: MRIs from 6 patients from a single center underwent quantitative analysis. In addition to direct measurements from postimplantation MRIs, the CRAnialVault Explorer suite was used to normalize electrode position to a common reference system...
2016: Stereotactic and Functional Neurosurgery
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