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Closed-loop Stimulation in Periods with Less Epileptiform Activity Drives Improved Epilepsy Outcomes by Daria Nesterovich Anderson; Chantel M Charlebois; Elliot H Smith; Tyler S Davis; Angela Y Peters; Blake J Newman; Amir M Arain; Karen S Wilcox; Christopher R Butson; John D Rolston is a Neuroscience article available to read on EtoBox.

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## Abstract In patients with drug-resistant epilepsy, electrical stimulation of the brain in response to epileptiform activity can make seizures less frequent and debilitating. This therapy, known as closed-loop responsive neurostimulation (RNS), aims to directly halt seizure activity via targeted stimulation of a burgeoning seizure. Rather than immediately stopping seizures as they start, many RNS implants produce slower, long-lasting changes in brain dynamics that better predict clinical outcomes. Here we hypothesize that stimulation during brain states with less epileptiform activity drives long-term changes that restore healthy brain networks. To test this, we quantified stimulation episodes during low- and high-risk brain states—that is, stimulation during periods with a lower or higher risk of generating epileptiform activity—in a cohort of 40 patients treated with RNS. More frequent stimulation in tonic low-risk states, and out of rhythmic high-risk states, predicted seizure reduction. Additionally, stimulation events were more likely to be phase-locked to prolonged episodes of abnormal activity for intermediate and poor responders when compared to super responders, consiste

Who reads Closed-loop Stimulation in Periods with Less Epileptiform Activity Drives Improved Epilepsy Outcomes?

Author

Daria Nesterovich Anderson; Chantel M Charlebois; Elliot H Smith; Tyler S Davis; Angela Y Peters; Blake J Newman; Amir M Arain; Karen S Wilcox; Christopher R Butson; John D Rolston

Publisher

Oxford University Press (OUP)

Published

2023

Field

Neuroscience (Life Sciences)