Chronic subthreshold cortical stimulation

a therapeutic and potentially restorative therapy for focal epilepsy

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Introduction: Approximately one third of patients with focal epilepsy continue to have ongoing seizures despite adequate trials of anti-seizure medications. Surgery to remove the epileptogenic zone remains the most efficacious treatment option for focal drug-resistant epilepsy. However, when cortical areas are eloquent or there are multiple epileptogenic zones, surgical resection is not an ideal approach. Cortical stimulation provides an attractive alternative. Area covered: Here, the authors describe Chronic Subthreshold Cortical Stimulation (CSCS), which uses continuous intracranial electrical stimulation applied near the epileptogenic zone to lower seizure probability. The authors review literature related to CSCS. One challenge is finding the most efficacious set of stimulation parameters for each patient. Expert commentary: Data supporting CSCS are limited but promising for the treatment of patients with focal drug resistant epilepsy who are not surgical candidates. Additional electrophysiological biomarkers to estimate cortical excitability are needed.

Original languageEnglish (US)
Pages (from-to)661-666
Number of pages6
JournalExpert Review of Neurotherapeutics
Volume17
Issue number7
DOIs
StatePublished - Jul 3 2017

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Partial Epilepsy
Seizures
Electric Stimulation
Therapeutics
Biomarkers
Drug Resistant Epilepsy

Keywords

  • chronic electrical stimulation
  • Cortical stimulation
  • drug-resistant epilepsy
  • focal seizures

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Neurology
  • Pharmacology (medical)

Cite this

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title = "Chronic subthreshold cortical stimulation: a therapeutic and potentially restorative therapy for focal epilepsy",
abstract = "Introduction: Approximately one third of patients with focal epilepsy continue to have ongoing seizures despite adequate trials of anti-seizure medications. Surgery to remove the epileptogenic zone remains the most efficacious treatment option for focal drug-resistant epilepsy. However, when cortical areas are eloquent or there are multiple epileptogenic zones, surgical resection is not an ideal approach. Cortical stimulation provides an attractive alternative. Area covered: Here, the authors describe Chronic Subthreshold Cortical Stimulation (CSCS), which uses continuous intracranial electrical stimulation applied near the epileptogenic zone to lower seizure probability. The authors review literature related to CSCS. One challenge is finding the most efficacious set of stimulation parameters for each patient. Expert commentary: Data supporting CSCS are limited but promising for the treatment of patients with focal drug resistant epilepsy who are not surgical candidates. Additional electrophysiological biomarkers to estimate cortical excitability are needed.",
keywords = "chronic electrical stimulation, Cortical stimulation, drug-resistant epilepsy, focal seizures",
author = "Lundstrom, {Brian Nils} and Worrell, {Gregory Alan} and Stead, {Squire Matthew} and {Van Gompel}, Jamie",
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AU - Lundstrom, Brian Nils

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AU - Stead, Squire Matthew

AU - Van Gompel, Jamie

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N2 - Introduction: Approximately one third of patients with focal epilepsy continue to have ongoing seizures despite adequate trials of anti-seizure medications. Surgery to remove the epileptogenic zone remains the most efficacious treatment option for focal drug-resistant epilepsy. However, when cortical areas are eloquent or there are multiple epileptogenic zones, surgical resection is not an ideal approach. Cortical stimulation provides an attractive alternative. Area covered: Here, the authors describe Chronic Subthreshold Cortical Stimulation (CSCS), which uses continuous intracranial electrical stimulation applied near the epileptogenic zone to lower seizure probability. The authors review literature related to CSCS. One challenge is finding the most efficacious set of stimulation parameters for each patient. Expert commentary: Data supporting CSCS are limited but promising for the treatment of patients with focal drug resistant epilepsy who are not surgical candidates. Additional electrophysiological biomarkers to estimate cortical excitability are needed.

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