Cited by 402Epilepsy research and treatmentDeep Brain Stimulation and Movement DisordersVagus Nerve Stimulation Research

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Electrical brain stimulation for epilepsy

Fisher, Robert S., Velasco, Ana Luisa·2014·Nature Reviews Neurology

DOI 10.1038/nrneurol.2014.59

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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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Self-citation
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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.
ORCID: Fisher, Robert S.
Velasco, Ana Luisa
Venue: Nature Reviews Neurology
Publisher: Springer Science and Business Media LLC
Published: 2014-04-08
Volume: 10
Issue: 5
Pages: 261-270
ISSN: 1759-4758 (ISSN-L)
1759-4766
DOI: 10.1038/nrneurol.2014.59
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 › Clinical Neurology › Epilepsy research and treatment
Health Sciences › Medicine › Clinical Neurology › Deep Brain Stimulation and Movement Disorders
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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