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Dbs and epilepsy

Byung-Chul Son, Young Min Shon, Seong-Hoon Kim, Jin-Gyu Choi, Jiyeon Kim
OBJECTIVES: Interpreting the postoperative electroencephalographic (EEG) driving response (DR) as an indicator of electrode placement within the thalamic nucleus in deep brain stimulation (DBS) of the anterior nucleus of the thalamus (ANT) for refractory epilepsy is controversial. MATERIALS AND METHODS: We retrospectively investigated the relationship between postoperative EEG DR and the location of 11 electrodes in 6 patients who underwent ANT DBS for refractory epilepsy...
October 11, 2016: Stereotactic and Functional Neurosurgery
Rosa Q So, Vibhor Krishna, Nicolas Kon Kam King, Huijuan Yang, Zhuo Zhang, Francesco Sammartino, Andres M Lozano, Richard A Wennberg, Cuntai Guan
OBJECTIVE The authors explored the feasibility of seizure detection and prediction using signals recorded from the anterior thalamic nucleus, a major target for deep brain stimulation (DBS) in the treatment of epilepsy. METHODS Using data from 5 patients (13 seizures in total), the authors performed a feasibility study and analyzed the performance of a seizure prediction and detection algorithm applied to simultaneously acquired scalp and thalamic electroencephalography (EEG). The thalamic signal was obtained from DBS electrodes...
October 7, 2016: Journal of Neurosurgery
John D Rolston, Dario J Englot, Philip A Starr, Paul S Larson
INTRODUCTION: Deep brain stimulation (DBS) is an established therapy for movement disorders, and is under active investigation for other neurologic and psychiatric indications. While many studies describe outcomes and complications related to stimulation therapies, the majority of these are from large academic centers, and results may differ from those in general neurosurgical practice. METHODS: Using data from both the Centers for Medicare and Medicaid Services (CMS) and the National Surgical Quality Improvement Program (NSQIP), we identified all DBS procedures related to primary placement, revision, or removal of intracranial electrodes...
September 12, 2016: Parkinsonism & related Disorders
Panagiotis N Papageorgiou, James Deschner, Spyridon N Papageorgiou
Background This umbrella review summarizes the evidence across meta-analyses regarding the effectiveness and adverse effects of deep brain stimulation (DBS). Methods Databases were searched up to March 2015 for meta-analyses of comparative trials in humans assessing the effectiveness or adverse effects of DBS. Data selection, data extraction, and risk of bias assessment were performed by two independent reviewers. Results Seven eligible systematic reviews were included assessing the use of DBS for epilepsy (n = 1), obsessive-compulsive disorder (n = 1), and Parkinson disease (n = 5)...
September 19, 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Hae Yu Kim, Yun Jung Hur, Heung-Dong Kim, Kang Min Park, Sung Eun Kim, Tae Gyu Hwang
OBJECTIVE Thalamic stimulation can provoke electroencephalography (EEG) synchronization or desynchronization, which can help to reduce the occurrence of seizures in intractable epilepsy, though the underlying mechanism is not fully understood. Therefore, the authors investigated changes in EEG electrical activity to better understand the seizure-reducing effects of deep brain stimulation (DBS) in patients with intractable epilepsy. METHODS Electrical activation patterns in the epileptogenic brains of 3 patients were analyzed using classical low-resolution electromagnetic tomography analysis recursively applied (CLARA)...
September 16, 2016: Journal of Neurosurgery
Masoud Amiri, Mahmood Amiri, Soheila Nazari, Karim Faez
Hyper-synchronous neural oscillations are the character of several neurological diseases such as epilepsy. On the other hand, glial cells and particularly astrocytes can influence neural synchronization. Therefore, based on the recent researches, a new bio-inspired stimulator is proposed which basically is a dynamical model of the astrocyte biophysical model. The performance of the new stimulator is investigated on a large-scale, cortical network. Both excitatory and inhibitory synapses are also considered in the simulated spiking neural network...
September 13, 2016: Journal of Theoretical Biology
Inuka Kishara Gooneratne, Alexander L Green, Patricia Dugan, Arjune Sen, Angelo Franzini, Tipu Aziz, Binith Cheeran
For patients with pharmacoresistant focal epilepsy in whom surgical resection of the epileptogenic focus fails or was not feasible in the first place, there were few therapeutic options. Increasingly, neurostimulation provides an alternative treatment strategy for these patients. Vagal nerve stimulation (VNS) is well established. Deep brain stimulation (DBS) and cortical responsive stimulation (CRS) are newer neurostimulation therapies with recently published long-term efficacy and safety data. In this literature review, we introduce these therapies to a non-specialist audience...
November 2016: Journal of Neurology, Neurosurgery, and Psychiatry
Catherine M Sweeney-Reed, Harim Lee, Stefan Rampp, Tino Zaehle, Lars Buentjen, Juergen Voges, Martin Holtkamp, Hermann Hinrichs, Hans-Jochen Heinze, Friedhelm C Schmitt
The relationships between interictal epileptiform discharges (IEDs) in the anterior (ANT) and dorsomedial nuclei (DMNT) of the thalamus and electro-clinical parameters in pharmacoresistant focal epilepsy patients receiving intrathalamic electrodes for deep brain stimulation (DBS) were investigated. Thalamus-localized IEDs (LIEDs) and surface EEG (sEEG)-IEDs were evaluated in eight patients who underwent ANT-DBS. Occurrence and frequency of ANT- and DMNT-LIEDs and pre-operative sEEG-IEDs were examined with respect to seizure onset location and seizure outcome following ANT-DBS...
October 2016: Journal of Neurology
Byung-Chul Son, Young Min Shon, Jin-Gyu Choi, Jiyeon Kim, Sang-Woo Ha, Sung-Hoon Kim, Si-Hoon Lee
OBJECTIVES: To investigate the clinical outcome of patients treated with chronic deep brain stimulation (DBS) of the centromedian nucleus (CM) for refractory epilepsy and to determine the location of active contacts. METHODS: The outcome of CM stimulation was evaluated as percent seizure reduction compared to the baseline 3 months. To establish the location of active contacts, 27 leads were studied in 14 patients with refractory epilepsy. An analysis was conducted to reveal whether any coordinates of the center of the active contacts predicted percent seizure reduction...
2016: Stereotactic and Functional Neurosurgery
Elena Jiltsova, Timo Möttönen, Markus Fahlström, Joonas Haapasalo, Timo Tähtinen, Jukka Peltola, Juha Öhman, Elna-Marie Larsson, Tommi Kiekara, Kai Lehtimäki
BACKGROUND: Deep brain stimulation (DBS) of the anterior nucleus of thalamus (ANT) is an evolving treatment option in refractory focal epilepsy. Due to poor visualization of ANT in traditional MRI sequences used for movement disorder surgery, targeting of ANT is mainly based on stereotactic atlas information. Sophisticated 3T MRI methods enable visualization of ANT, but 1.5T MRI is still preferred or more readily available in a large number of centers performing DBS. OBJECTIVE: In the present study, we sought to determine whether ANT could be adequately visualized at 1...
July 11, 2016: Neuromodulation: Journal of the International Neuromodulation Society
Markus Gschwind, Margitta Seeck
Complete seizure control is achieved in 40-50% of all epileptic patients with drug treatment, as reported in most epidemiological studies. Many effective antiepileptic drugs with a favourable profile are available in Switzerland, allowing treatment tailored to the patient's needs. Unfortunately, up to 40-50% of all patients will eventually relapse (pharmacoresistant epilepsy). These patients run a high risk of additional morbidity and mortality. Possible pharmacoresistant epilepsy should be considered early in the disease, when there is a lack of response to the first antiepileptic drug, since only 14% of those will respond to a second drug, and only 2% to a third drug if the second fails too...
2016: Swiss Medical Weekly
William S Gibson, Erika K Ross, Seong Rok Han, Jamie J Van Gompel, Hoon-Ki Min, Kendall H Lee
BACKGROUND: Deep brain stimulation (DBS) of the anterior thalamic nucleus (ATN) exerts its effects by modulating neural circuits involved in seizures. However, these networks remain incompletely characterized. OBJECTIVE: Investigate the effects of ATN DBS on network activity in a large animal model using 3-T fMRI. METHODS: Anesthetized swine underwent ATN DBS using stimulation parameters applied in the Stimulation of the Anterior Thalamus for the Treatment of Epilepsy (SANTE) trial...
September 2016: Brain Stimulation
Roberta K Sefcik, Nicholas L Opie, Sam E John, Christopher P Kellner, J Mocco, Thomas J Oxley
Current standard practice requires an invasive approach to the recording of electroencephalography (EEG) for epilepsy surgery, deep brain stimulation (DBS), and brain-machine interfaces (BMIs). The development of endovascular techniques offers a minimally invasive route to recording EEG from deep brain structures. This historical perspective aims to describe the technical progress in endovascular EEG by reviewing the first endovascular recordings made using a wire electrode, which was followed by the development of nanowire and catheter recordings and, finally, the most recent progress in stent-electrode recordings...
May 2016: Neurosurgical Focus
Timo Möttönen, Jani Katisko, Joonas Haapasalo, Timo Tähtinen, Antti Saastamoinen, Jukka Peltola, Juha Öhman, Kai Lehtimäki
BACKGROUND: Deep brain stimulation (DBS) of the anterior nucleus of the thalamus) (ANT) has been suggested as a treatment option in refractory epilepsy. The targeting of ANT is especially challenging due to its poor visualization in commonly used MRI sequences, lack of easily observable symptom relief during surgery and high degree of anatomical variation between individuals. OBJECTIVES: To study whether intraoperative microelectrode recording (MER), a method widely used in movement disorder surgery, provides clinically relevant information during the ANT-DBS implantation procedure...
2016: Stereotactic and Functional Neurosurgery
Anna Bersano, Michela Morbin, Elisa Ciceri, Gloria Bedini, Peter Berlit, Michele Herold, Stefania Saccucci, Valeria Fugnanesi, Hannes Nordmeyer, Giuseppe Faragò, Mario Savoiardo, Franco Taroni, MariaRita Carriero, Battista Boncoraglio Giorgio, Laura Perucca, Luigi Caputi, Agostino Parati Eugenio, Markus Kraemer
Divry van Bogaert Syndrome (DBS) is a familial juvenile-onset disorder characterized by livedo racemosa, white matter disease, dementia, epilepsy and angiographic finding of "cerebral angiomatosis". A similar syndrome including livedo racemosa and cerebrovascular disease, often associated with anticardiolipin antibodies, has been described as Sneddon Syndrome (SS) highlighting the question whether these two conditions have to be considered different entities or indeed different features of a unique syndrome...
May 15, 2016: Journal of the Neurological Sciences
Da-Wei Meng, Huan-Guang Liu, An-Chao Yang, Kai Zhang, Jian-Guo Zhang
BACKGROUND: The antiepileptic effect of the anterior thalamic nuclei (ANT) stimulation has been demonstrated; however, its underlying mechanism remains unclear. The aim of this study was to investigate the effect of chronic ANT stimulation on hippocampal neuron loss and apoptosis. METHODS: Sixty-four rats were divided into four groups: The control group, the kainic acid (KA) group, the sham-deep brain stimulation (DBS) group, and the DBS group. KA was used to induce epilepsy...
April 20, 2016: Chinese Medical Journal
Simone Rossi, Emiliano Santarnecchi, Gaetano Valenza, Monica Ulivelli
Neuromodulation refers to invasive, minimally invasive or non-invasive techniques to stimulate discrete cortical or subcortical brain regions with therapeutic purposes in otherwise intractable patients: for example, thousands of advanced Parkinsonian patients, as well as patients with tremor or dystonia, benefited by deep brain stimulation (DBS) procedures (neural targets: basal ganglia nuclei). A new era for DBS is currently opening for patients with drug-resistant depression, obsessive-compulsive disorders, severe epilepsy, migraine and chronic pain (neural targets: basal ganglia and other subcortical nuclei or associative fibres)...
May 13, 2016: Philosophical Transactions. Series A, Mathematical, Physical, and Engineering Sciences
Salim Yalcin Inan, Burak Cem Soner, Ayse Saide Sahin
Parkinson's disease (PD) is one of the most common neurodegenerative disorders, which affects more than six million people in the world. While current available pharmacological therapies for PD in the early stages of the disease usually improve motor symptoms, they cause side effects, such as fluctuations and dyskinesias in the later stages. In this later stage, high frequency deep brain stimulation of the subthalamic nucleus (STN-DBS) is a treatment option which is most successful to treat drug resistant advanced PD...
August 2016: Metabolic Brain Disease
Roberta Morace, Giancarlo DI Gennaro, Pierpaolo Quarato, Alfredo D'Aniello, Addolorata Amascia, Liliana Grammaldo, Marco DE Risi, Antonio Sparano, Michelangelo DE Angelis, Francesco DI Cola, Domenico Solari, Vincenzo Esposito
INTRODUCTION: Deep brain stimulation (DBS) is currently considered a promising neuromodulation therapy for refractory epilepsy not suitable for resective surgery. Several anatomical targets and different stimulation approaches have been proposed in order to obtain satisfactory seizures reduction. As expected, according with different patterns of neural pathways involvement, the efficacy of each anatomical target stimulation in reducing seizure frequency varies among the different epileptic syndromes...
June 2016: Journal of Neurosurgical Sciences
Hongbo Jin, Wenling Li, Changzheng Dong, Jiang Wu, Wenqing Zhao, Zengyi Zhao, Li Ma, Fa Ma, Yao Chen, Qianwei Liu
PURPOSE: To evaluate the efficacy of chronic continuous hippocampal deep brain stimulation (DBS) in nonlesional refractory mesial temporal lobe epilepsy. METHODS: Three adult patients with medically intractable epilepsy treated with hippocampal DBS were studied. Two patients underwent invasive recordings with depth stereo-electroencephalography (SEEG) electrodes to localize ictal onset zone prior to implantation of DBS electrodes. All the patients with no lesion in brain magnetic resonance imaging (MRI) scan received bilateral implantation of DBS electrodes...
April 2016: Seizure: the Journal of the British Epilepsy Association
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