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Optimisation of deep brain stimulation in epilepsy

English title Optimisation of deep brain stimulation in epilepsy
Applicant Boex Colette
Number 118385
Funding scheme Project funding (Div. I-III)
Research institution Laboratoire d'Évaluation Préchirurgicale des Epilepsies Hôpital Universitaire Cantonal de Genève
Institution of higher education University of Geneva - GE
Main discipline Neurophysiology and Brain Research
Start/End 01.10.2007 - 30.09.2010
Approved amount 268'862.00
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Keywords (3)

Epilepsy; Deep brain stimulation; EEG

Lay Summary (English)

Lead
Lay summary
Deep brain stimulation (DBS) is emerging as a possible treatment for intractable epilepsy, which affects 0.2-0.3% of the population. It has been applied at multiple sites of the brain, for different epileptic syndromes. While DBS has been demonstrated to be efficient in some epileptic patients, many patients do not respond. The present research project is aimed at optimizing the DBS treatment of pharmaco-resistant epilepsies, including bio-physical electrical properties of DBS, taking into account the clinical characteristics of each patient’s cerebral activity. We aim at determining the minimal and most efficient stimulation that is required to prevent seizures and that guarantees a safe stimulation, on the basis of the neurophysiological study of the cerebral activity, spontaneous or evoked by electrical stimulation. In addition, we propose to implement seizure detection and anticipation algorithms which have been described as useful so that stimulation is delivered on-demand to block the occurrence and/or propagation of seizures. The present research project will participate to better understand the mechanisms of action of DBS, in particular on the epileptogenic activity. Some of the gained insights will also be useful for other neurological and psychiatric diseases, for which DBS has been used or discussed (e.g. Parkinson’s disease, essential tremor, dystonia, pain, Tourette’s syndrome).
Direct link to Lay Summary Last update: 21.02.2013

Responsible applicant and co-applicants

Employees

Publications

Publication
Comparison of high gamma electrocorticography and fMRI with electrocortical stimulation for localization of somatosensory and language cortex
Genetti M (2015), Comparison of high gamma electrocorticography and fMRI with electrocortical stimulation for localization of somatosensory and language cortex, in Clin Neurophysiol, 126(1), 10.
Effects of amygdala—hippocampal stimulation on synchronization
Tyrand R (2014), Effects of amygdala—hippocampal stimulation on synchronization, in Epilepsy Research, 108, 4.
CHRONIC DEEP BRAIN STIMULATION IN MESIAL TEMPORAL LOBE EPILEPSY
Boex Colette (2011), CHRONIC DEEP BRAIN STIMULATION IN MESIAL TEMPORAL LOBE EPILEPSY, in Seizure, 16(8), 6.
Effects of amygdala—hippocampal stimulation on interictal epileptic discharges
Tyrand R (2011), Effects of amygdala—hippocampal stimulation on interictal epileptic discharges, in Epilepsy Research, 7.

Associated projects

Number Title Start Funding scheme
133080 Integration of advanced biomarkers to deep brain stimulation in epilepsy 01.10.2010 Project funding (Div. I-III)

Abstract

Deep brain stimulation (DBS) is emerging as a possible treatment for intractable epilepsy, which affects 0.2-0.3% of the population. It has been applied at multiple sites of the brain, for different epileptic syndromes. While DBS has been demonstrated to be efficient in some epileptic patients, many patients do not respond. Simply employing the same protocols as used for movement disorders (MD) research might not be sufficient. In fact, different brain structures are stimulated in MD patients compared to epilepsy. Therefore, it needs to be assessed if the same stimulus parameters also serve in epileptic patients. The present research proposal is aimed at investigating the physical properties of electrical stimulation to increase its efficiency. Only few studies have been done in humans, and the lack of effect of DBS in a significant proportion of patients might be due to sub-optimal parameters. The project also aims at implementing real-time seizure detection and anticipation algorithms so that stimulation is delivered on-demand to block the occurrence and/ or propagation of seizures. The patients who are explored invasively with intracranial electrodes will be investigated during and after DBS of several hours. The effects of DBS on the patient’s EEG will be carried out with state-of-the-art methods: evoked cortical potentials, interictal spike rates, spectral analyses, seizure frequency. The following parameters will be determined: shape of stimuli, mono- vs bipolar configuration, pulse width, frequency, duration, amplitude. We aim at determining the minimal and most efficient stimulation that is required to prevent seizures and that guarantees a safe stimulation. In addition, we propose to implement seizure recognition algorithms which have been described as useful, but not yet employed for long-term DBS with adjusted parameters. Significance: Epilepsy is a chronic disease in a significant part of the population which are still in need of additional treatment options. Deep brain stimulation has been applied with success to many pharmacoresistant, non-operable patients. However, in order to improve the efficacy of DBS and enhance our understanding of this technique, we need to improve our knowledge on the biophysical aspects of the stimulation. While the present grant addresses epileptic patients, some of the gained insights will also be useful for other neurological and psychiatric diseases, for whom DBS has been used or discussed (e.g. movement disorders, pain, essential tremor, Tourette’s syndrom, depression, addiction).
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