Chapter category: Neuroscience
Brain Stimulation as a Therapy for Epilepsy
Recent Advances in Epilepsy Research
Edited by: Devin K. Binder and Helen E. ScharfmanISBN: 0-306-47860-9
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Chapter authors:
Jeffrey H. Goodman
The failure of current antiepileptic therapies to adequately treat a significant number of epileptic patients highlights the need for the development of new treatments for the disorder. A new strategy that is currently being developed is to deliver electrical stimulation directly to the brain to decrease or prevent seizure activity. Clinical evidence that electrical stimulation could interfere with seizure activity was initially reported in the 1930’s. However, many of these early studies consisted of case reports or were poorly controlled. In addition, there were a number of studies that failed to observe any beneficial effect of brain stimulation on seizures. More recently, deep brain stimulation has been used successfully to treat patients with movement disorders and vagus nerve stimulation has been shown to effectively decrease seizure activity in a select population of epilepsy patients. These advances have led to a reexamination of the potential therapeutic benefits of deep brain stimulation for the treatment of epilepsy. There is now experimental and clinical evidence that direct electrical stimulation of the brain can prevent or decrease seizure activity. However, several fundamental questions remain to be resolved. They include where in the brain the stimulus should be delivered and what type of stimulation would be most effective. One goal of this research is to combine the beneficial aspects of electrical stimulation with seizure detection technology in an implantable responsive stimulator. The device will detect the onset of a seizure and deliver an electrical stimulus that will safely block seizure activity without interfering with normal brain function.
Additional chapters from this book:
The Tetanus Toxin Model of Chronic Epilepsy
Timothy A. Benke and John Swann
In experimental models of epilepsy, single and recurrent seizures are often used in an attempt to determine the effects of the seizures themselves on mammalian brain function. These models attempt t...
Functional Implications of Seizure-Induced Neurogenesis
Helen E. Scharfman
The neurobiological doctrine governing the concept of neurogenesis has undergone a revolution in the past few years. What was once considered dubious is now well accepted: new neurons are born in th...
Malformations of Cortical Development: Molecular Pathogenesis and Experimental Strategies
Peter B. Crino
Malformations of cortical development (MCD) are developmental brain lesions characterized by abnormal formation of the cerebral cortex and a high clinical association with epilepsy in infants, child...
Using the Immune System to Target Epilepsy
Deborah Young and Matthew J. During
The sudden and transient disruption from normal brain function by the disordered, synchronous and rhythmic firing of populations of neurons or seizures is the common feature of a diverse collection ...
Functional Role of Proinflammatory and Anti-Inflammatory Cytokines in Seizures
Annamaria Vezzani, Daniela Moneta, Cristina Richichi, Carlo Perego and Maria G. De Simoni
Recent evidence has shown that proinflammatory and anti-inflammatory molecules are synthesized during epileptic activity in glial cells in CNS regions where seizures initiate and spread. These molec...
Gap Junctions, Fast Oscillations and the Initiation of Seizures
Roger D. Traub, Hillary Michelson-Law, Andrea E.J. Bibbig, Eberhard H. Buhl and Miles A. Whittington
In this chapter, we shall review evidence that gap junctions can contribute to epileptogenesis in the hippocampus and cortex—but not just any gap junctions. Rather, we shall argue for a role for a n...
Role of the Depolarizing GABA Response in Epilepsy
Kevin J. Staley
The term “seizure” underscores two fundamental characteristics of epileptic phenomena: they are sudden and unexpected deviations from the normal function of the nervous system. Thus 2 important crit...
Role of the GABA Transporter in Epilepsy
George B. Richerson and Yuanming Wu
The GABA transporter plays a well-established role in reuptake of GABA after synaptic release. The anticonvulsant effect of tiagabine appears to result largely from blocking this reuptake. However, ...
Plasticity Mechanisms Underlying mGluR-Induced Epileptogenesis
Robert K.S. Wong, Shih-Chieh Chuang and Riccardo Bianchi
Transient application of group I metabotropic glutamate receptor (mGluR) agonists to hippocampal slices produces ictal-like discharges that persist for hours after the removal of the agonist. This e...
Vascular Endothelial Growth Factor (VEGF) in Seizures: A Double-Edged Sword
Susan D. Croll, Jeffrey H. Goodman and Helen E. Scharfman
Vascular endothelial growth factor (VEGF) is a vascular growth factor which induces angiogenesis (the development of new blood vessels), vascular permeability, and inflammation. In brain, receptors ...
The Role of BDNF in Epilepsy and Other Diseases of the Mature Nervous System
Devin K. Binder
The neurotrophin brain-derived neurotrophic factor (BDNF) is ubiquitous in the central nervous system (CNS) throughout life. In addition to trophic effects on target neurons, BDNF appears to be part...
Genetic Approaches to Studying Mouse Models of Human Seizure Disorders
Yan Yang and Wayne N. Frankel
Epilepsy, characterized by recurrent spontaneous seizures resulting from abnormal, synchronized discharges of neurons in the brain, is one of the most common neurological problems afflicting humans....
Cortical Dysplasia and Epilepsy: Animal Models
Philip A. Schwartzkroin, Steven N. Roper and H. Jurgen Wenzel
Cortical dysplasia syndromes – those conditions of abnormal brain structure/organiza- tion that arise during aberrant brain development – frequently involve epileptic sei- zures. Neuropathological...
Brain Stimulation as a Therapy for Epilepsy
Jeffrey H. Goodman
The failure of current antiepileptic therapies to adequately treat a significant number of epileptic patients highlights the need for the development of new treatments for the disorder. A new st...
Integrins, Synaptic Plasticity and Epileptogenesis
Christine M. Gall and Gary Lynch
A number of processes are thought to contribute to the development of epilepsy inclu- ding enduring increases in excitatory synaptic transmission, changes in GABAergic inhi- bition, neuronal cell ...
GABA and its Receptors in Epilepsy
Günther Sperk, Sabine Furtinger, Christoph Schwarzer and Susanne Pirker
g-Aminobutyric acid (GABA) is the principal inhibitory neurotransmitter in the mammalian brain. It acts through 2 classes of receptors, GABAA receptors that are ligand-operated ion channels and the G-...
Febrile Seizures and Mechanisms of Epileptogenesis: Insights from an Animal Model
Roland A. Bender, Celine Dubé and Tallie Z. Baram
Temporal lobe epilepsy (TLE) is the most prevalent type of human epilepsy, yet the causes for its development, and the processes involved, are not known. Most individuals with TLE do not have a family...
