Experimental Electrical Stimulation Therapy for Epilepsy

Stanford Department of Neurology, Room A343, Stanford Medical Center, 300 Pasteur Drive, Stanford, CA 94305, USA. .
Current Treatment Options in Neurology (Impact Factor: 1.94). 08/2005; 7(4):261-271. DOI: 10.1007/s11940-005-0036-9
Source: PubMed


Electrical stimulation of the nervous system is an attractive possible therapy for intractable epilepsy, but only stimulation of the vagus nerve has been subjected to large, controlled, and completed clinical trials. Controlled trials are in progress for intermittent cycling stimulation of the anterior nuclei of the thalamus, and for cortical stimulation at a seizure focus, responsive to detection of seizure onset. Anecdotal experience has been gathered with stimulation of cerebellum, centromedian thalamus, subthalamus, caudate, hippocampus, and brainstem. All stimulation of the central nervous system for epilepsy must be considered experimental.

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    • "These paradoxical effects can be beneficial as well as detrimental. Understanding the mechanisms both of stimulation and seizures, and their interactions, will help develop effective brain stimulation therapy to control epilepsy (Nakagawa & Durand, 1991; Durand & Bikson, 2001; Oommen et al., 2005). "
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    ABSTRACT: Brain stimulation is currently used as an experimental treatment for patients with medically refractory epilepsy. However, the results of such stimulation are still less than optimal. A major factor is the lack of understanding of the mechanisms of applied stimuli. Herein we review evidence on the effects of stimulation in models of epileptic seizures. We show that the effects of stimulation during epileptic seizures can differ from those observed under normal conditions. Several studies suggest a potentially greater beneficial therapeutic effect of strong depolarizing and overactivating stimulations than hyperpolarizing ones in the treatment of seizures. The potential relevance of these results to other therapeutic stimulation protocols is discussed.
    Epilepsia 07/2010; 51 Suppl 3(s3):93-7. DOI:10.1111/j.1528-1167.2010.02619.x · 4.57 Impact Factor
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    • "Up to one in three individuals with epilepsy suffers from intractable seizures (Oommen et al., 2005), requiring the development of alternative treatments to antiepileptic medication . The administration of low-frequency stimulation (LFS) to the neocortex through subdural electrodes is a treatment that decreases ictal and interictal spiking in patients with neocortical (Kinoshita et al., 2005) and mesial temporal lobe epilepsy (TLE) (Yamamoto et al., 2002, 2006). "
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    ABSTRACT: Low-frequency stimulation applied through indwelling electrodes has been used to depress or depotentiate synaptic efficacy. Moreover it has been reported to inhibit seizure expression and progression when started either during or after seizures. We have recently shown that low-frequency stimulation can also reduce the size of seizure-enlarged movement representations (motor maps) when delivered after 30 afterdischarges that had propagated from the hippocampus to the neocortex. This study was designed to examine the effects of low-frequency stimulation delivered to the corpus callosum on motor map topography when applied during or after each elicited seizure. Specifically, 15 min of 1 Hz stimulation was applied to the corpus callosum either concurrent with or immediately following a neocortical afterdischarge that had propagated from the hippocampus. Long-Evans hooded rats were electrically stimulated twice daily in the right ventral hippocampus until the first neocortical afterdischarge was elicited. Rats then received low-frequency stimulation which began either with the afterdischarge or following each afterdischarge for 20 additional kindling sessions; a sham low-frequency stimulation group was also included. Afterdischarges were recorded from both hippocampal and neocortical sites, and seizure expression was documented. One to six days following the last stimulation session, forelimb movement representations were derived using high-resolution intracortical microstimulation in the left sensorimotor neocortex. Low-frequency stimulation following each kindled seizure, suppressed behavioral seizure severity and hippocampal afterdischarge duration, as well as attenuated kindling-induced motor map expansion.
    Neuroscience 04/2009; 160(2):567-75. DOI:10.1016/j.neuroscience.2009.02.066 · 3.36 Impact Factor
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