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Electrical Stimulation for the Treatment of Epilepsy

Paul Boon UGent, Robrecht Raedt UGent, Veerle De Herdt UGent, Tine Wyckhuys UGent and Kristl Vonck UGent (2009) Neurotherapeutics. 6(2). p.218-227
abstract
Despite the advent of new pharmacological treatments and the high success rate of many surgical treatments for epilepsy, a substantial number of patients either do not become seizure-free or they experience major adverse events (or both). Neurostimulation-based treatments have gained considerable interest in the last decade. Vagus nerve stimulation (VNS) is an alternative treatment for patients with medically refractory epilepsy, who are unsuitable candidates for conventional epilepsy surgery, or who have had such surgery without optimal outcome. Although responder identification studies are lacking, long-term VNS studies show response rates between 40% and 50% and long-term seizure freedom in 5% to 10% of patients. Surgical complications and perioperative morbidity are low. Research into the mechanism of action of VNS has revealed a crucial role for the thalamus and cortical areas that are important in the epileptogenic process. Acute deep brain stimulation (DBS) in various thalamic nuclei and medial temporal lobe structures has recently been shown to be efficacious in small pilot studies. There is little evidence-based information on rational targets and stimulation parameters. Amygdalohippocampal DBS has yielded a significant decrease of seizure counts and interictal EEG abnormalities during long-term follow-up. Data from pilot studies suggest that chronic DBS for epilepsy may be a feasible, effective, and safe procedure. Further trials with larger patient populations and with controlled, randomized, and closed-loop designs should now be initiated. Further progress in understanding the mechanism of action of DBS for epilepsy is a necessary step to making this therapy more efficacious and established.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (proceedingsPaper)
publication status
published
subject
keyword
vagus nerve stimulation, hippocampal stimulation, neurostimulation, Refractory epilepsy, electrical stimulation, epilepsy surgery
journal title
Neurotherapeutics
volume
6
issue
2
pages
218 - 227
publisher
Elsevier Science Inc
place of publication
NY 10010 USA
conference name
4th Workshop on New Horizons in the Development of Antiepileptic Drugs
conference location
Dublin, Ireland
conference start
2008-03-05
conference end
2008-03-07
Web of Science type
Proceedings Paper
Web of Science id
000264659900002
JCR category
PHARMACOLOGY & PHARMACY
JCR impact factor
5.381 (2009)
JCR rank
17/236 (2009)
JCR quartile
1 (2009)
ISSN
1933-7213
language
English
UGent publication?
yes
classification
A1
id
610927
handle
http://hdl.handle.net/1854/LU-610927
date created
2009-05-08 14:46:07
date last changed
2009-05-15 11:57:28
@article{610927,
  abstract     = {Despite the advent of new pharmacological treatments and the high success rate of many surgical treatments for epilepsy, a substantial number of patients either do not become seizure-free or they experience major adverse events (or both). Neurostimulation-based treatments have gained considerable interest in the last decade. Vagus nerve stimulation (VNS) is an alternative treatment for patients with medically refractory epilepsy, who are unsuitable candidates for conventional epilepsy surgery, or who have had such surgery without optimal outcome. Although responder identification studies are lacking, long-term VNS studies show response rates between 40\% and 50\% and long-term seizure freedom in 5\% to 10\% of patients. Surgical complications and perioperative morbidity are low. Research into the mechanism of action of VNS has revealed a crucial role for the thalamus and cortical areas that are important in the epileptogenic process. Acute deep brain stimulation (DBS) in various thalamic nuclei and medial temporal lobe structures has recently been shown to be efficacious in small pilot studies. There is little evidence-based information on rational targets and stimulation parameters. Amygdalohippocampal DBS has yielded a significant decrease of seizure counts and interictal EEG abnormalities during long-term follow-up. Data from pilot studies suggest that chronic DBS for epilepsy may be a feasible, effective, and safe procedure. Further trials with larger patient populations and with controlled, randomized, and closed-loop designs should now be initiated. Further progress in understanding the mechanism of action of DBS for epilepsy is a necessary step to making this therapy more efficacious and established.},
  author       = {Boon, Paul and Raedt, Robrecht and De Herdt, Veerle and Wyckhuys, Tine and Vonck, Kristl},
  issn         = {1933-7213},
  journal      = {Neurotherapeutics},
  keyword      = {vagus nerve stimulation,hippocampal stimulation,neurostimulation,Refractory epilepsy,electrical stimulation,epilepsy surgery},
  language     = {eng},
  location     = {Dublin, Ireland},
  number       = {2},
  pages        = {218--227},
  publisher    = {Elsevier Science Inc},
  title        = {Electrical Stimulation for the Treatment of Epilepsy},
  volume       = {6},
  year         = {2009},
}

Chicago
Boon, Paul, Robrecht Raedt, VEERLE DE HERDT, Tine Wyckhuys, and Kristl Vonck. 2009. “Electrical Stimulation for the Treatment of Epilepsy.” Neurotherapeutics 6 (2): 218–227.
APA
Boon, P., Raedt, R., DE HERDT, V., Wyckhuys, T., & Vonck, K. (2009). Electrical Stimulation for the Treatment of Epilepsy. Neurotherapeutics, 6(2), 218–227. Presented at the 4th Workshop on New Horizons in the Development of Antiepileptic Drugs.
Vancouver
1.
Boon P, Raedt R, DE HERDT V, Wyckhuys T, Vonck K. Electrical Stimulation for the Treatment of Epilepsy. Neurotherapeutics. NY 10010 USA: Elsevier Science Inc; 2009;6(2):218–27.
MLA
Boon, Paul, Robrecht Raedt, VEERLE DE HERDT, et al. “Electrical Stimulation for the Treatment of Epilepsy.” Neurotherapeutics 6.2 (2009): 218–227. Print.