Neurostimulation targeting the epileptic focus: Current understanding and perspectives for treatment.

Journal: Seizure

Volume: 117

Issue: 

Year of Publication: 

Affiliated Institutions:  Epilepsy Center, University Medical Center, University of Freiburg, Germany; European Reference Network EpiCare, Belgium; NeuroModul Basic, University of Freiburg, Freiburg, Germany. Electronic address: andreas.schulze-bonhage@uniklinik-freiburg.de. Dept. Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany; Bielefeld University, University Hospital OWL, Protestant Hospital of Bethel Foundation, University Clinic of Psychiatry and Psychotherapy, Germany; German Center for Mental Health (DZPG), Germany. Bernstein Center Freiburg & Faculty of Biology, University of Freiburg, Germany. Epilepsy Center, Clinic for Neurology, University Medical Center Göttingen, Germany. Department of Neurology and Weill Institute for Neurosciences, University of California, San Francisco, USA.

Abstract summary 

For the one third of people with epilepsy whose seizures are not controlled with medications, targeting the seizure focus with neurostimulation can be an effective therapeutic strategy. In this focused review, we summarize a discussion of targeted neurostimulation modalities during a workshop held in Frankfurt, Germany in September 2023. Topics covered include: available devices for seizure focus stimulation; alternating current (AC) and direct current (DC) stimulation to reduce focal cortical excitability; modeling approaches to simulate DC stimulation; reconciling the efficacy of focal stimulation with the network theory of epilepsy; and the emerging concept of 'neurostimulation zones,' which are defined as cortical regions where focal stimulation is most effective for reducing seizures and which may or may not directly involve the seizure onset zone. By combining experimental data, modeling results, and clinical outcome analysis, rational selection of target regions and stimulation parameters is increasingly feasible, paving the way for a broader use of neurostimulation for epilepsy in the future.

Authors & Co-authors:  Schulze-Bonhage Nitsche Rotter Focke Rao

Study Outcome 

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Statistics
Citations : 
Authors :  5
Identifiers
Doi : 10.1016/j.seizure.2024.03.001
SSN : 1532-2688
Study Population
Male,Female
Mesh Terms
Other Terms
AC stimulation;DC stimulation;Epileptic focus;Epileptic network;Neurostimulation
Study Design
Study Approach
Country of Study
Publication Country
England