Electrical brain stimulation for epilepsy
Abstract
Neurostimulation enables adjustable and reversible modulation of disease symptoms, including those of epilepsy. Two types of brain neuromodulation, comprising anterior thalamic deep brain stimulation and responsive neurostimulation at seizure foci, are supported by Class I evidence of effectiveness, and many other sites in the brain have been targeted in small trials of neurostimulation therapy for seizures. Animal studies have mainly assisted in the identification of potential neurostimulation sites and parameters, but much of the clinical work is only loosely based on fundamental principles derived from the laboratory, and the mechanisms by which brain neurostimulation reduces seizures remain poorly understood. The benefits of stimulation tend to increase over time, with maximal effect seen typically 1-2 years after implantation. Typical reductions of seizure frequency are approximately 40% acutely, and 50-69% after several years. Seizure intensity might also be reduced. Complications from brain neurostimulation are mainly associated with the implantation procedure and hardware, including stimulation-related paraesthesias, stimulation-site infections, electrode mistargeting and, in some patients, triggered seizures or even status epilepticus. Further preclinical and clinical experience with brain stimulation surgery should lead to improved outcomes by increasing our understanding of the optimal surgical candidates, sites and parameters.
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Brain implants have shown significant efficacy in improving quality of life for conditions including Parkinson's disease, ALS, movement disorders, epilepsy, and mental health issues.
“They have shown significant efficacy in improving the quality of life for those suffering from a range of conditions, including but not limited to Parkinson’s disease, ALS (Willett et al., 2023), movement disorders, epilepsy, and mental health issues (Fisher and Velasco, 2014; Bergfeld et al., 2016; França et al., 2022).”
From Comparative analysis of energy transfer mechanisms for neural implants (2024) · cites this paper as Fisher and Velasco, 2014
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- Authors
- Fisher, R. S., & Velasco, A. L.
- Affiliations
- Stanford Medicine (US)
- Hospital General de México (MX)
- Corresponding author
- Fisher, Robert S.
- Venue
- Nature Reviews Neurology
- Published
- 2014-04-08
- Volume
- 10
- Issue
- 5
- Pages
- 261-270
- ISSN
- 1759-4758 (ISSN-L)
- 1759-4766
- OpenAlex
- W2080438790
- Cited by
- 402
- References
- 118
- Citations by year
- 2026: 23 · 2025: 44 · 2024: 36 · 2023: 29 · 2022: 36 · 2021: 28 · 2020: 35 · 2019: 45 · 2018: 24 · 2017: 29 · 2016: 34 · 2015: 30 · 2014: 9
- FWCI
- 4.68
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Nature Reviews Neurology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Neurological Disorders and Stroke (NS44601-01)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Epilepsy research and treatment
- Health Sciences › Medicine › Neurology › Neurological disorders and treatments
- Life Sciences › Neuroscience › Neurology › Vagus Nerve Stimulation Research
- Keywords
- deep brain stimulation, epilepsy, responsive neurostimulation, anterior thalamic nuclei, seizure foci, electrical neuromodulation, seizure frequency reduction, stimulation parameters, implantation complications, status epilepticus, surgical candidates, animal models of epilepsy
- MeSH terms
- Brain, Epilepsy, Humans, Deep Brain Stimulation
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