Search For New Targets of Deep Brain Stimulation For Epilepsy Treatment - Search For New Targets of Deep Brain Stimulation For Epilepsy Treatment - Open Access Pub

Although clinical trials in refractory epilepsy are currently carried out, the field of deep brain stimulation (DBS) in epilepsy is still at its initial stage. Little is known about where, when and how to stimulate and what would be the short and long consequences. Animal studies might provide clinicians with new ideas regarding targets for DBS. Here an overview is given regarding old and new targets in rodent models of temporal lobe epilepsy. The evidence from animal models showed that stimulation of the subiculum – either in responsive or scheduled manner - is anticonvulsant in different seizure and epilepsy models, indicating that the subiculum might be a promising candidate for DBS targets. For the rest, the antiepileptic effects of low frequency stimulation were established mostly in kindling models. The presence of a critical time window in which stimulation was effective following after discharges on kindling acquisition, demonstrates that timing of DBS is an important factor for the anticonvulsant effects of DBS. DOI10.14302/issn.2470-5020.jnrt-15-800 Nearly one third patients with epilepsy, despite with treatment of antiepileptic drugs (AEDs), still have incompletely controlled seizures or debilitating medication effects1. Deep brain stimulation (DBS) is a promising treatment for epileptic patients who are not proper candidates for resective surgery. DBS delivers current to the brain via implanted electrode to reduce or control seizures. Compared to the classic resective surgery, DBS is reversible, can be user-customized and has fewer complications. Stimulation is commonly delivered according to a predefined protocol, that is, scheduled stimulation, independent of the neurophysiologic state of the brain. In contrast, responsive stimulation refers to stimulation that is delivered directly in response to electrographic epileptic activities. Responsive stimulation can target seizure dynamics with higher temporal specificity and save battery power for implanted stimulation devices 2. With development of brain computer interface systems in real time seizure analysis, responsive stimulation has received more attention in clinical trials and animal research. An example of schema of delivery of responsive stimulation in rat model was given in Figure 1. Figure 1. Schema of delivery of responsive stimulation in a closed-loop BCI (brain computer interface) system. EEG signal was at first obtained via implanted electrodes from rats, amplified, band-pass and notch filtered with a physiological amplifier (made by Electronic Research Group, Radboud