TY - JOUR

T1 - Acute effects of brain-responsive neurostimulation in drug-resistant partial onset epilepsy

AU - Rønborg, Søren N.

AU - Esteller, Rosana

AU - Tcheng, Thomas K.

AU - Greene, David A.

AU - Morrell, Martha J.

AU - Wesenberg Kjaer, Troels

AU - Arcot Desai, Sharanya

N1 - Publisher Copyright: © 2021 International Federation of Clinical Neurophysiology

PY - 2021

Y1 - 2021

N2 - 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.

AB - 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.

KW - Drug resistant epilepsy

KW - Electrical stimulation of the brain

KW - Epilepsy

KW - Intracranial EEG

KW - Neurostimulation

KW - Responsive neurostimulation

U2 - 10.1016/j.clinph.2021.03.013

DO - 10.1016/j.clinph.2021.03.013

M3 - Journal article

C2 - 33931295

AN - SCOPUS:85106119317

VL - 132

SP - 1209

EP - 1220

JO - Clinical Neurophysiology

JF - Clinical Neurophysiology

SN - 1388-2457

IS - 6

ER -