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Efficacy of low and high frequency Deep Brain Stimulation in epilepsy

Paul Boon UGent and Tine Wyckhuys UGent (2008) WMSCI 2008: 12TH WORLD MULTI-CONFERENCE ON SYSTEMICS, CYBERNETICS AND INFORMATICS, VOL II, PROCEEDINGS. p.153-153
abstract
Purpose: Deep brain stimulation using a neurocybernetic device and intracranially implanted electrodes is currently being investigated as a treatment for refractory epilepsy. Several brain structures such as the cerebellum and the thalamus have been targeted. At Ghent University Hospital a pilot trial in patients using hippocampal DBS has shown a significant reduction in seizure frequency in patients with temporal lobe epilepsy. The current stimulation parameters that are being used are not evidence based. Further improvement of clinical efficacy may result from research towards the identificition of optimal stimulation parameters in specific seizure types. This study investigated the efficacy of hippocampal DBS using two different stimulation frequencies in a validated animal model for temporal lobe epilepsy. Methods: Twenty rats were transformed into epileptic rats using the alternate day rapid kindling model, that makes use of electrical stimuli in the amygdala. When fully kindled, these rats have a seizure each time an electrical stimulus is administered in the hippocampus. For therapeutic hippocampal stimulation rats were devided into a 130 Hz (HFS) group and a 5 Hz (LFS) stimulation group. Rats received 10 days of therapeutic hippocampal DBS. During and after termination of therapeutic DBS, seizures were evoked in all rats using the amygdalar electrical stimulation. Typical seizure characteristics such as afterdischarge (AD) threshold, latency and duration were compared between both treatment groups. Results: During HFS, AD threshold and AD latency showed a significantly larger increase (P<0.05 and p<0.005 respectively) compared to the rats that received LFS (p=0.48 and p<0.05 respectively).In the HFS group the AD duration was shorter (p<0.05) compared to baseline. This was not observed in the LFS group. After termination of DBS, effects faded out slowly. Discussion and Conclusion: Both HFS and LFS of the hippocampus in epileptic rats resulted in reduced excitability that is typical for epileptic seizures. When HFS and LFS were compared, HFS was more efficacious the n LFS as reflected in a higher AD threshold and AD latency and a shorter AD duration during treatment. This study is the first to show clear evidence in favour of HFS of the hippocampus to treat seizures.
Please use this url to cite or link to this publication:
author
organization
year
type
conference
publication status
published
subject
in
WMSCI 2008: 12TH WORLD MULTI-CONFERENCE ON SYSTEMICS, CYBERNETICS AND INFORMATICS, VOL II, PROCEEDINGS
pages
1 pages
conference name
12th World Multi-Conference on Systemics, Cybernetics and Informatics/14th International Conference on Information Systems Analysis and Synthesis
conference location
Orlando, USA
conference start
2008-06-29
conference end
2008-07-02
Web of Science type
Proceedings Paper
Web of Science id
000263828700036
ISBN
978-1-934272-32-9
language
English
UGent publication?
yes
classification
P1
id
664669
handle
http://hdl.handle.net/1854/LU-664669
date created
2009-05-25 14:33:10
date last changed
2009-05-28 16:19:03
@inproceedings{664669,
  abstract     = {Purpose:
Deep brain stimulation using a neurocybernetic device and intracranially implanted electrodes is currently being investigated as a treatment for refractory epilepsy. Several brain structures such as the cerebellum and the thalamus have been targeted. At Ghent University Hospital a pilot trial in patients using hippocampal DBS has shown a significant reduction in seizure frequency in patients with temporal lobe epilepsy. The current stimulation parameters that are being used are not evidence based. Further improvement of clinical efficacy may result from research towards the identificition of optimal stimulation parameters in specific seizure types. This study investigated the efficacy of hippocampal DBS using two different stimulation frequencies in a validated animal model for temporal lobe epilepsy.
Methods:
Twenty rats were transformed into epileptic rats using the alternate day rapid kindling model, that makes use of electrical stimuli in the amygdala. When fully kindled, these rats have a seizure each time an electrical stimulus is administered in the hippocampus. For therapeutic hippocampal stimulation rats were devided into a 130 Hz (HFS) group and a 5 Hz (LFS) stimulation group.  Rats received 10 days of therapeutic hippocampal DBS. During and after termination of therapeutic DBS, seizures were evoked in all rats using the amygdalar electrical stimulation. Typical seizure characteristics such as afterdischarge (AD) threshold, latency and duration were compared between both treatment groups.  
Results:
During HFS, AD threshold and AD latency showed a significantly larger increase (P{\textlangle}0.05 and p{\textlangle}0.005 respectively) compared to the rats that received LFS (p=0.48 and p{\textlangle}0.05 respectively).In the HFS group the AD duration was shorter (p{\textlangle}0.05) compared to baseline. This was not observed in the LFS group. After termination of DBS, effects faded out slowly.
 
Discussion and Conclusion:
Both HFS and LFS of the hippocampus in epileptic rats resulted in reduced excitability that is typical for epileptic seizures. When HFS and LFS were compared, HFS was more efficacious the n LFS as reflected in a higher AD threshold and AD latency and a shorter AD duration during treatment. This study is the first to show clear evidence in favour of HFS of the hippocampus to treat seizures.},
  author       = {Boon, Paul and Wyckhuys, Tine},
  booktitle    = {WMSCI 2008: 12TH WORLD MULTI-CONFERENCE ON SYSTEMICS, CYBERNETICS AND INFORMATICS, VOL II, PROCEEDINGS},
  isbn         = {978-1-934272-32-9},
  language     = {eng},
  location     = {Orlando, USA},
  pages        = {153--153},
  title        = {Efficacy of low and high frequency Deep Brain Stimulation in epilepsy},
  year         = {2008},
}

Chicago
Boon, Paul, and Tine Wyckhuys. 2008. “Efficacy of Low and High Frequency Deep Brain Stimulation in Epilepsy.” In WMSCI 2008: 12TH WORLD MULTI-CONFERENCE ON SYSTEMICS, CYBERNETICS AND INFORMATICS, VOL II, PROCEEDINGS, 153–153.
APA
Boon, P., & Wyckhuys, T. (2008). Efficacy of low and high frequency Deep Brain Stimulation in epilepsy. WMSCI 2008: 12TH WORLD MULTI-CONFERENCE ON SYSTEMICS, CYBERNETICS AND INFORMATICS, VOL II, PROCEEDINGS (pp. 153–153). Presented at the 12th World Multi-Conference on Systemics, Cybernetics and Informatics/14th International Conference on Information Systems Analysis and Synthesis.
Vancouver
1.
Boon P, Wyckhuys T. Efficacy of low and high frequency Deep Brain Stimulation in epilepsy. WMSCI 2008: 12TH WORLD MULTI-CONFERENCE ON SYSTEMICS, CYBERNETICS AND INFORMATICS, VOL II, PROCEEDINGS. 2008. p. 153–153.
MLA
Boon, Paul, and Tine Wyckhuys. “Efficacy of Low and High Frequency Deep Brain Stimulation in Epilepsy.” WMSCI 2008: 12TH WORLD MULTI-CONFERENCE ON SYSTEMICS, CYBERNETICS AND INFORMATICS, VOL II, PROCEEDINGS. 2008. 153–153. Print.