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Expert Review of Neurotherapeutics Volume 15, 2015 - Issue 12
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Reviews

Responsive neurostimulation in epilepsy

Sofie CarretteLaboratory for Clinical and Experimental Neurophysiology, Neurobiology and Neuropsychology (LCEN3), Ghent University, Department of Neurology, Ghent University Hospital, Institute for Neuroscience, Ghent, BelgiumCorrespondence[email protected]
,
Paul BoonLaboratory for Clinical and Experimental Neurophysiology, Neurobiology and Neuropsychology (LCEN3), Ghent University, Department of Neurology, Ghent University Hospital, Institute for Neuroscience, Ghent, Belgium
,
Mathieu SprengersLaboratory for Clinical and Experimental Neurophysiology, Neurobiology and Neuropsychology (LCEN3), Ghent University, Department of Neurology, Ghent University Hospital, Institute for Neuroscience, Ghent, Belgium
,
Robrecht RaedtLaboratory for Clinical and Experimental Neurophysiology, Neurobiology and Neuropsychology (LCEN3), Ghent University, Department of Neurology, Ghent University Hospital, Institute for Neuroscience, Ghent, Belgium
&
Kristl VonckLaboratory for Clinical and Experimental Neurophysiology, Neurobiology and Neuropsychology (LCEN3), Ghent University, Department of Neurology, Ghent University Hospital, Institute for Neuroscience, Ghent, Belgium
Pages 1445-1454 | Published online: 18 Nov 2015

References

  • Papers of special note have been highlighted as:
  • ● of interest
  • ●● of considerable interest
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● Report of the multicenter, double-blind, randomized controlled trial that assessed the safety and effectiveness of the RNS system as an adjunctive therapy for partial onset seizures in adults with medically refractory epilepsy. This study provided Class I evidence that responsive cortical stimulation is effective in significantly reducing seizure frequency in adults who have failed two or more anti-epileptic medication trials, three or more seizures per month, and one or two seizure foci. Subsequently, the RNS system was granted FDA clearance for this indication.

  • Lesser RP, Kim SH, Beyderman L, et al. Brief bursts of pulse stimulation terminate after discharges caused by cortical stimulation. Neurology. 1999;53(9):2073–2081.
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●● The authors give an overview of the current clinical experience with closed-loop stimulation for the treatment of pain, epilepsy and movement disorders.

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● Report of the multicenter, double-blind, randomized trial of bilateral stimulation of the anterior nuclei of the thalamus for localization-related epilepsy that led to its FDA clearance for this indication. Bilateral ANT-DBS was shown to reduce seizures and benefit persisted for 2 years of study.

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●● Provides a clear overview on Vagus Nerve Stimulation, highlighting its assumed mechanism of action, the implantation procedure and clinical results achieved through years of clinical experience.

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● Report of the multicenter, prospectively randomized, parallel, double-blind study of vagus nerve stimulation in patients with refractory partial seizures. This study confirmed the effectiveness of VNS as treatment for epilepsy patients with refractory partial seizures and ultimately led to the FDA clearance of VNS for this indication.

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