Acute effects of brain-responsive neurostimulation in drug-resistant partial onset epilepsy

Søren N Rønborg, Rosana Esteller, Thomas K Tcheng, David A Greene, Martha J Morrell, Troels Wesenberg Kjaer, Sharanya Arcot Desai

Publikation: Bidrag til tidsskriftArtikelForskningpeer review

Abstrakt

OBJECTIVE: Understanding the acute effects of responsive stimulation (AERS) based on intracranial EEG (iEEG) recordings in ambulatory patients with drug-resistant partial epilepsy, and correlating these with changes in clinical seizure frequency, may help clinicians more efficiently optimize responsive stimulation settings.

METHODS: In patients implanted with the NeuroPace® RNS® System, acute changes in iEEG spectral power following active and sham stimulation periods were quantified and compared within individual iEEG channels. Additionally, acute stimulation-induced acute iEEG changes were compared within iEEG channels before and after patients experienced substantial reductions in clinical seizure frequency.

RESULTS: Responsive stimulation resulted in a 20.7% relative decrease in spectral power in the 2-4 second window following active stimulation, compared to sham stimulation. On several detection channels, the AERS features changed when clinical outcomes improved but were relatively stable otherwise. AERS change direction associated with clinical improvement was generally consistent within detection channels.

CONCLUSIONS: In this retrospective analysis, patients with drug-resistant partial epilepsy treated with direct brain-responsive neurostimulation showed an acute stimulation related reduction in iEEG spectral power that was associated with reductions in clinical seizure frequency.

SIGNIFICANCE: Identifying favorable stimulation related changes in iEEG activity could help physicians to more rapidly optimize stimulation settings for each patient.

OriginalsprogEngelsk
Sider (fra-til)1209-1220
Antal sider12
TidsskriftClinical Neurophysiology
Vol/bind132
Udgave nummer6
Tidlig onlinedato31 mar. 2021
DOI
StatusUdgivet - jun. 2021

Bibliografisk note

Copyright © 2021 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

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