2020
Nine-year prospective efficacy and safety of brain-responsive neurostimulation for focal epilepsy
Nair DR, Laxer KD, Weber PB, Murro AM, Park YD, Barkley GL, Smith BJ, Gwinn RP, Doherty MJ, Noe KH, Zimmerman RS, Bergey GK, Anderson WS, Heck C, Liu CY, Lee RW, Sadler T, Duckrow RB, Hirsch LJ, Wharen RE, Tatum W, Srinivasan S, McKhann GM, Agostini MA, Alexopoulos AV, Jobst BC, Roberts DW, Salanova V, Witt TC, Cash SS, Cole AJ, Worrell GA, Lundstrom BN, Edwards JC, Halford JJ, Spencer DC, Ernst L, Skidmore CT, Sperling MR, Miller I, Geller EB, Berg MJ, Fessler AJ, Rutecki P, Goldman AM, Mizrahi EM, Gross RE, Shields DC, Schwartz TH, Labar DR, Fountain NB, Elias WJ, Olejniczak PW, Villemarette-Pittman NR, Eisenschenk S, Roper SN, Boggs JG, Courtney TA, Sun FT, Seale CG, Miller KL, Skarpaas TL, Morrell MJ. Nine-year prospective efficacy and safety of brain-responsive neurostimulation for focal epilepsy. Neurology 2020, 95: 10.1212/wnl.0000000000010154. PMID: 32690786, PMCID: PMC7538230, DOI: 10.1212/wnl.0000000000010154.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedDepressive DisorderDrug Resistant EpilepsyElectric Stimulation TherapyEpilepsies, PartialFemaleFollow-Up StudiesHumansImplantable NeurostimulatorsIntracranial HemorrhagesMaleMemory DisordersMiddle AgedProspective StudiesProsthesis-Related InfectionsQuality of LifeRandomized Controlled Trials as TopicStatus EpilepticusSudden Unexpected Death in EpilepsySuicideTreatment OutcomeYoung AdultConceptsBrain-responsive neurostimulationQuality of lifeFocal onset seizuresAdverse eventsSeizure frequencyIntractable focal onset seizuresProspective open-label trialOverall QOLOpen-label trialSerious adverse eventsClass IV evidenceMedian percent reductionSudden unexplained deathMedian percent changeSeizure-free periodQOLIE-89SUDEP ratesLabel trialSeizure freedomEpilepsy ratesFocal seizuresOnset seizuresEpilepsy InventoryAcceptable safetyFocal epilepsy
2018
Seizure susceptibility and infraslow modulatory activity in the intracranial electroencephalogram
Joshi RB, Duckrow RB, Goncharova II, Gerrard JL, Spencer DD, Hirsch LJ, Godwin DW, Zaveri HP. Seizure susceptibility and infraslow modulatory activity in the intracranial electroencephalogram. Epilepsia 2018, 59: 2075-2085. PMID: 30187919, DOI: 10.1111/epi.14559.Peer-Reviewed Original ResearchConceptsAED taperYale-New Haven HospitalAdult epilepsy patientsSeizure forecasting algorithmsElectrode contact pairsSeizure onset areaSeizure susceptibilityClinical recordsDrug taperElectrophysiological changesEpilepsy patientsIntracranial electroencephalographic dataMagnitude-squared coherenceModulatory activitySeizuresPatientsOnset areaPreseizurePostseizureProgressive desynchronizationIntracranial electroencephalogramDaysIctogenesisEffect of timeHospital
2017
Brain‐responsive neurostimulation in patients with medically intractable mesial temporal lobe epilepsy
Geller EB, Skarpaas TL, Gross RE, Goodman RR, Barkley GL, Bazil CW, Berg MJ, Bergey GK, Cash SS, Cole AJ, Duckrow RB, Edwards JC, Eisenschenk S, Fessler J, Fountain NB, Goldman AM, Gwinn RP, Heck C, Herekar A, Hirsch LJ, Jobst BC, King‐Stephens D, Labar DR, Leiphart JW, Marsh WR, Meador KJ, Mizrahi EM, Murro AM, Nair DR, Noe KH, Park YD, Rutecki PA, Salanova V, Sheth RD, Shields DC, Skidmore C, Smith MC, Spencer DC, Srinivasan S, Tatum W, Van Ness PC, Vossler DG, Wharen RE, Worrell GA, Yoshor D, Zimmerman RS, Cicora K, Sun FT, Morrell MJ. Brain‐responsive neurostimulation in patients with medically intractable mesial temporal lobe epilepsy. Epilepsia 2017, 58: 994-1004. PMID: 28398014, DOI: 10.1111/epi.13740.Peer-Reviewed Original ResearchConceptsMesial temporal lobe epilepsyMesial temporal sclerosisSeizure-free periodTemporal lobe epilepsySeizure reductionAdverse eventsLobe epilepsyIntractable mesial temporal lobe epilepsySerious device-related adverse eventsIntractable partial-onset seizuresMedian percent seizure reductionMesial temporal lobe originBilateral mesial temporal lobe epilepsyDevice-related adverse eventsBrain-responsive neurostimulationImplant site infectionPercent seizure reductionPartial-onset seizuresProspective clinical trialsTemporal lobe originVagus nerve stimulationEffective treatment optionPercent of subjectsPreimplantation baselineTemporal sclerosisBrain‐responsive neurostimulation in patients with medically intractable seizures arising from eloquent and other neocortical areas
Jobst BC, Kapur R, Barkley GL, Bazil CW, Berg MJ, Bergey GK, Boggs JG, Cash SS, Cole AJ, Duchowny MS, Duckrow RB, Edwards JC, Eisenschenk S, Fessler AJ, Fountain NB, Geller EB, Goldman AM, Goodman RR, Gross RE, Gwinn RP, Heck C, Herekar AA, Hirsch LJ, King‐Stephens D, Labar DR, Marsh WR, Meador KJ, Miller I, Mizrahi EM, Murro AM, Nair DR, Noe KH, Olejniczak PW, Park YD, Rutecki P, Salanova V, Sheth RD, Skidmore C, Smith MC, Spencer DC, Srinivasan S, Tatum W, Van Ness P, Vossler DG, Wharen RE, Worrell GA, Yoshor D, Zimmerman RS, Skarpaas TL, Morrell MJ. Brain‐responsive neurostimulation in patients with medically intractable seizures arising from eloquent and other neocortical areas. Epilepsia 2017, 58: 1005-1014. PMID: 28387951, DOI: 10.1111/epi.13739.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultBrain MappingCerebral CortexDeep Brain StimulationDrug Resistant EpilepsyElectric Stimulation TherapyElectrodes, ImplantedElectroencephalographyEpilepsies, PartialEpilepsy, Complex PartialEpilepsy, Partial, MotorEpilepsy, Tonic-ClonicFeasibility StudiesFemaleFollow-Up StudiesHumansMaleMiddle AgedNeocortexYoung AdultConceptsSeizure-free periodSeizure reductionNeocortical onsetSeizure onsetNeocortical originIntractable partial-onset seizuresMedian percent seizure reductionBrain-responsive neurostimulationChronic neurologic deficitsPercent seizure reductionPrior epilepsy surgeryPartial-onset seizuresPercent of patientsProspective clinical trialsNormal MRI findingsVagus nerve stimulationEffective treatment optionEloquent cortical areasRate of infectionMagnetic resonance imagingPreimplantation baselineMRI lesionsAdverse eventsNeurologic deficitsPerioperative hemorrhage
2016
Elevated basal glutamate and unchanged glutamine and GABA in refractory epilepsy: Microdialysis study of 79 patients at the yale epilepsy surgery program
Çavuş I, Romanyshyn JC, Kennard JT, Farooque P, Williamson A, Eid T, Spencer SS, Duckrow R, Dziura J, Spencer DD. Elevated basal glutamate and unchanged glutamine and GABA in refractory epilepsy: Microdialysis study of 79 patients at the yale epilepsy surgery program. Annals Of Neurology 2016, 80: 35-45. PMID: 27129611, DOI: 10.1002/ana.24673.Peer-Reviewed Original ResearchConceptsGABA levelsEpilepsy patientsΓ-aminobutyric acid (GABA) neurotransmissionGlutamine levelsGABAergic antiepileptic drugsEpilepsy surgery programRefractory epilepsy patientsCommon pathological featureAberrant glutamateAnn NeurolNonepileptogenic cortexSeizure-onset sitesRefractory epilepsyBasal glutamateAntiepileptic drugsCortical lesionsMicrodialysis studyPatient groupInterictal levelsPathological featuresDifferent etiologiesNeocortical epilepsyGlutamate levelsSeizure generationElectroencephalogram evaluationThe relationship between seizures, interictal spikes and antiepileptic drugs
Goncharova II, Alkawadri R, Gaspard N, Duckrow RB, Spencer DD, Hirsch LJ, Spencer SS, Zaveri HP. The relationship between seizures, interictal spikes and antiepileptic drugs. Clinical Neurophysiology 2016, 127: 3180-3186. PMID: 27292227, DOI: 10.1016/j.clinph.2016.05.014.Peer-Reviewed Original ResearchConceptsFirst seizureSeizure occurrenceAED taperSpike rateEEG monitoringMarker of inhibitionIntracranial EEG monitoringOccurrence of seizuresScalp EEG monitoringConsecutive patientsAntiepileptic drugsDrug taperHigh spike ratesInterictal spikesSeizuresDay 4Intracranial electrodesPatientsAEDsSignificant relationship50 Hz hippocampal stimulation in refractory epilepsy: Higher level of basal glutamate predicts greater release of glutamate
Cavus I, Widi GA, Duckrow RB, Zaveri H, Kennard JT, Krystal J, Spencer DD. 50 Hz hippocampal stimulation in refractory epilepsy: Higher level of basal glutamate predicts greater release of glutamate. Epilepsia 2016, 57: 288-297. PMID: 26749134, DOI: 10.1111/epi.13269.Peer-Reviewed Original ResearchConceptsBasal glutamate levelsRefractory epilepsyGlutamate effluxBasal glutamateGlutamate levelsElectrical stimulationEpileptic hippocampusGlutamate releaseSeizure groupHz stimulationBrain glutamate releaseHippocampus of patientsStimulation-induced increaseEpilepsy monitoring unitStimulation-induced changesEpileptogenic hippocampusInduced seizuresSeizure inductionSpontaneous seizuresInterictal levelsGlutamate increaseAtrophic hippocampusElectroencephalography evaluationHippocampal stimulationHippocampal electrodes