Navigation Links
Deep brain stimulation reduces epileptic seizures in patients with refractory partial and secondarily generalized seizures
Date:3/17/2010

A recent study organized by Stanford University researchers found patients with refractory partial and secondarily generalized seizures had a reduction in seizures after deep brain stimulation. This multi-center clinical trial determined that the benefits of stimulation of the anterior nuclei of thalamus for epilepsy (SANTE) persisted and by 2 years there was a 56% reduction in seizure frequency. Full findings of this study are available early online in Epilepsia, a journal published by Wiley-Blackwell on behalf of the International League Against Epilepsy.

Epilepsy, a common neurological disorder, is characterized by recurrent seizures that can cause temporary loss of consciousness, convulsions, confusion or disturbances in sensations. According to the World Health Organization (WHO), epilepsy affects 50 million people worldwide. Past studies indicate that one-third of those with epilepsy do not respond adequately to antiepileptic drugs (AEDs).

"Electrical deep brain stimulation (DBS) is a promising therapy for epilepsy," said Robert Fisher, M.D., Ph.D., Director of the Epilepsy Center at Stanford University, and lead author of the SANTE study. "Our goal is to find treatments that reduce the effects of epilepsy, particularly for those who don't respond to AED therapy."

The SANTE clinical trial included 110 participants, 18-65 years of age with partial seizures occurring at least 6 times per month (not more than 10 per day), and whose seizures failed to respond to at least 3 AED treatments. After a 3-month baseline with stable AED use, DBS electrodes were implanted in the anterior nuclei of thalamus (ANT) bilaterally using a stereotactic technique. One month after implantation, participants were randomized to stimulation at 5 V or no stimulation at 0 V (control group), using 90 s pulses, 145 pulses/s, "ON" 1 minute, and "OFF" 5 minutes in a 3-month blinded treatment phase. (month 1 to month 4). All participants then received stimulation (from month 4 to month 13) in an unblinded "open label" phase of the trial.

Results showed those in the stimulation group had a 40.4% decline in seizures compared with 14.5% decline in the control group (blinded phase), and this difference was statistically significant, provided that seizures occurring in one patient transiently triggered by the stimulation cycle were discounted. Complex partial seizures, seizures listed as "most severe" by the subject and injuries from seizures all were reduced during the blinded phase in the stimulated group. Responder rate, (the percentage of patients whose seizures were cut in half or better) did not differ in the blinded phase, but improved long-term with respect to baseline.

Long-term follow-up began at 13 months post-implantation and included 105 participants all receiving stimulation. At 13 months, 41% of patients showed a reduction in seizures; at 25 months, 56% of patients experienced a reduction. Two participants were seizure-free from months 4-13 and 14 (12.7%) were seizure-free for at least 6 months of the trial. During the trial, no participant had symptomatic hemorrhage or brain infection. Researchers noted 5 deaths, none believed to be related to implantation or stimulation. Subjects in the stimulated group more often reported subjective depression and memory impairments, usually extensions of pre-exisitng problems.

"We found that bilateral DBS of the ANT does reduce seizure frequency in patients unresponsive to other treatments," concluded Dr. Fisher. The SANTE research team noted improvements in some participants who previously were not helped by multiple AEDs, vagus nerve stimulation, or epilepsy surgery. "While our study did not produce serious complications, DBS therapy is invasive and serious complications can occur," Dr. Fisher cautioned. "Additional clinical knowledge would help to determine the best candidates for DBS therapy and establish ideal stimulation parameters."

On March 12, 2010, an FDA advisory panel recommended approval of DBS in the anterior nucleus of thalamus as being safe and effective for patients with severe and refractory partial seizures with or without secondary generalization.


'/>"/>

Contact: Dawn Peters
medicalnews@wiley.com
781-388-8408
Wiley-Blackwell
Source:Eurekalert

Related medicine news :

1. Draining away brains toxic protein to stop Alzheimers
2. Vision restoration therapy shown to improve brain activity in brain injured patients
3. Clinical depression linked to abnormal emotional brain circuits
4. Brain imaging reveals breakdown of normal emotional processing
5. Brain cells work differently than previously thought
6. Vaccine Stops Alzheimers Brain Tangles
7. Research may unlock mystery of autisms origin in the brain
8. Scientists Spot Brains Free Will Center
9. Free will takes flight: how our brains respond to an approaching menace
10. Alcoholics With Cirrhosis Have More Brain Damage
11. Brain Lesions Predict MS Progression
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:7/26/2017)... ... , ... Six greater Bay Area roller derby leagues are partnering with Brown Paper Tickets and ... series of blood drives in California, beginning July 29. Make ‘Em Bleed roller derby blood ... enough to have helped to save up to 2700 lives. , “The Make ‘Em Bleed ...
(Date:7/26/2017)... ... July 26, 2017 , ... “We are dentists and we ... from San Jose, Calif., “so we invented the MAGNETIC/ LOCK BRACKETS.” , The patent-pending ... orthodontic braces. In doing so, it offers an effective alternative to traditional braces. As ...
(Date:7/26/2017)... ATLANTA, Ga. (PRWEB) , ... July 26, 2017 , ... ... and equal access to medicine for everyone affected by diabetes, is excited to announce ... of its Global Ambassador Program. , Established in 2005, the Team Type 1 ...
(Date:7/26/2017)... ... July 26, 2017 , ... Isodiol ... global cannabis innovator, specializing in the development of pharmaceutical and consumer products, announces ... 2017 to June 30, 2017. Iso International LLC recorded unaudited fiscal Q1 profits ...
(Date:7/26/2017)... ... July 26, 2017 , ... The number of adults ... United States, but ways to improve asthma control in the population are not well ... Practice (JACI: In Practice), an official journal of the American Academy of Allergy, Asthma ...
Breaking Medicine News(10 mins):
(Date:7/13/2017)... 13, 2017  Centurion Medical Products, a leader in medical product ... fecal impaction removal device for hospice patient care. ... Centurion Medical Products ... Patient pain management and emotional comfort are part ... alleviate patient pain while preventing unneeded emergency department admission due to ...
(Date:7/12/2017)... July 12, 2017  Eli Lilly and Company (NYSE: ... generic companies to resolve pending patent litigation in the U.S. ... regarding the Cialis ® (tadalafil) unit dose ... 26, 2020. As part of the agreement, Cialis exclusivity is ... 2018. "The unit dose patent for Cialis is ...
(Date:7/11/2017)... , July 11, 2017  Sysmex America, Inc., ... diagnostic testing equipment as well as middleware information ... way to make quality assurance easier and more ... is well known for the innovation that it ... Monitor elevates quality assurance processes to a new ...
Breaking Medicine Technology: