Responsive neurostimulation: Review of clinical trials and insights into focal epilepsy

Epilepsy & Behavior : E&B
Eric B Geller

Abstract

The responsive neurostimulator (RNS ®, NeuroPace Inc.) has been available clinically since 2013 for the treatment of medically refractory partial epilepsy. Using intracranial electrodes and a cranially implanted device, RNS ® provides on-demand electrical cortical stimulation to reduce seizures. A randomized, multicenter, double-blind clinical trial demonstrated seizure reduction compared with sham stimulation. Seizure reduction was improved and sustained over years in a long-term treatment trial. The RNS ® provides chronic ambulatory electrographic monitoring over years giving unprecedented insight into epilepsy dynamics. Studies to date have looked at the length of time to detecting bilateral seizure onsets in mesial temporal lobe epilepsy (MTLE), demonstrated biorhythms in interictal epileptiform activity over varied time scales, and shown promise in early detection of benefits of adding a new antiepileptic drug. Questions remain as to the boundaries of patient selection and lead placement. "This article is part of the Supplement issue Neurostimulation for Epilepsy."

Citations

Dec 13, 2019·Epilepsia·Brandy B MaVikram R Rao
Oct 23, 2019·Brain Sciences·Keith StarnesBrian Nils Lundstrom
Aug 3, 2020·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Soha A Alomar, Rothaina J Saeedi
May 16, 2019·Journal of Korean Neurosurgical Society·Ji Hoon Phi, Byung-Kyu Cho
Aug 21, 2019·CNS Neuroscience & Therapeutics·Jing-Jing FanQun Wang
Sep 29, 2020·Journal of Epilepsy Research·Sora AnHyang Woon Lee
Oct 8, 2020·Brain Sciences·Niels Alexander FoitNeda Ladbon-Bernasconi
Nov 20, 2020·Neurologia Medico-chirurgica·Takamichi Yamamoto
Dec 4, 2020·Neurologia Medico-chirurgica·Motoki InajiWerner K Doyle
Mar 26, 2021·Expert Review of Medical Devices·Dirk De RidderSven Vanneste
Sep 3, 2021·AJOB Neuroscience·Tobias HaeusermannDaniel Dohan

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