Abstracts

Systematic Review on Translational Models of Deep Brain Stimulation for Epilepsy

Abstract number : 3.136
Submission category : 2. Translational Research / 2D. Models
Year : 2022
Submission ID : 2204238
Source : www.aesnet.org
Presentation date : 12/5/2022 12:00:00 PM
Published date : Nov 22, 2022, 05:24 AM

Authors :
Kristina Zhang, – The Hospital for Sick Children; Flavia Venetucci Gouveia, Dr. – Neuroscience and Mental Health – The Hospital for Sick Children; George Ibrahim, Dr. – Neurosurgery – The Hospital for Sick Children

Rationale: Drug-resistant epilepsy, characterized by recurrent seizures despite adequate trials and doses of anti-epileptic medications, affects approximately one-third of patients with epilepsy. Neuromodulation techniques, such as deep brain stimulation (DBS), have recently become available as an alternative treatment option to reduce seizure burden. DBS is a minimally-invasive surgery that involves implantation of electrodes into deep brain targets to deliver electrical stimulation and modulate dysfunctional neurocircuitries. Several questions remain on the efficacy and underlying mechanisms of DBS at varying brain targets. Preclinical studies of DBS in rat and mouse models of epilepsy have shed light on the pathophysiology behind this treatment option. In this systematic review, we sought to identify studies applying DBS to rat and mouse models of epilepsy and provide a synthesis of the literature on the brain targets and stimulation parameters used, as well as insights on possible mechanisms of action.

Methods: A systematic review was conducted using the PubMed database. Experimental in vivo DBS studies conducted using rat or mouse models of epilepsy that reported stimulation target and parameters, as well as behavioural or multiscale neurobiological outcomes were included. The main outcomes on seizure activity and neurophysiology, along with the methods and electrical parameters of each DBS brain target were extracted.

Results: Of 210 resultant articles, 37 were included. These studies reported targeting eight unique brain structures with different clinically significant electrical parameters and durations. The majority of studies revealed an improvement of seizure activity following DBS intervention; albeit the extent of improvement was dependent on the seizure model used and DBS parameters applied.

Conclusions: The results of our review show a largely beneficial effect of DBS on seizure frequency and duration, with the extent of seizure improvement dependent on stimulation target and parameters. Overall, this systematic summary reveals the encouraging advances in defining optimal anatomical targets, ideal stimulation parameters and devices, as well as underlying mechanisms of action of DBS for the treatment of intractable epilepsy.

Funding: None
Translational Research