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
2019
Slowing less than 1 Hz is decreased near the seizure onset zone
Lundstrom BN, Boly M, Duckrow R, Zaveri HP, Blumenfeld H. Slowing less than 1 Hz is decreased near the seizure onset zone. Scientific Reports 2019, 9: 6218. PMID: 30996228, PMCID: PMC6470162, DOI: 10.1038/s41598-019-42347-y.Peer-Reviewed Original ResearchConceptsSeizure onset zoneOnset zoneFocal slowingFocal cerebral dysfunctionLocation of dysfunctionFocal epilepsy patientsSlow wave activitySlow oscillationsLocal synaptic strengthsSlow oscillation activityCerebral dysfunctionReduced inhibitory activityPostictal statePostictal slowingEpilepsy patientsModulatory effectsSynaptic strengthDelta frequencyCortical mechanismsIntracranial recordingsDistinct neural mechanismsIntracranial electroencephalographyNeural mechanismsDysfunctionSleep
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
2015
Long-term treatment with responsive brain stimulation in adults with refractory partial seizures
Bergey GK, Morrell MJ, Mizrahi EM, Goldman A, King-Stephens D, Nair D, Srinivasan S, Jobst B, Gross RE, Shields DC, Barkley G, Salanova V, Olejniczak P, Cole A, Cash SS, Noe K, Wharen R, Worrell G, Murro AM, Edwards J, Duchowny M, Spencer D, Smith M, Geller E, Gwinn R, Skidmore C, Eisenschenk S, Berg M, Heck C, Van Ness P, Fountain N, Rutecki P, Massey A, O'Donovan C, Labar D, Duckrow RB, Hirsch LJ, Courtney T, Sun FT, Seale CG. Long-term treatment with responsive brain stimulation in adults with refractory partial seizures. Neurology 2015, 84: 810-817. PMID: 25616485, PMCID: PMC4339127, DOI: 10.1212/wnl.0000000000001280.Peer-Reviewed Original ResearchConceptsRefractory partial-onset seizuresPartial-onset seizuresRefractory partial seizuresOnset seizuresQuality of lifePartial seizuresResponsive neurostimulatorSerious device-related adverse eventsMedian percent seizure reductionGeneralized tonic-clonic seizuresOpen-label safety studyDevice-related adverse eventsImplant site infectionPercent seizure reductionResponsive brain stimulationClass IV evidenceTonic-clonic seizuresDirect cortical stimulationLong-term efficacyLong-term treatmentRNS SystemDirect neurostimulationSeizure reductionAdverse eventsSite infection
2014
Subclinical seizures during intracranial EEG recording: Are they clinically significant?
Farooque P, Duckrow R. Subclinical seizures during intracranial EEG recording: Are they clinically significant? Epilepsy Research 2014, 108: 1790-1796. PMID: 25306063, DOI: 10.1016/j.eplepsyres.2014.09.020.Peer-Reviewed Original ResearchConceptsPoor surgical outcomesGood surgical outcomeSubclinical seizuresSurgical outcomesClinical seizuresIntracranial EEG recordingsGroup 2Group 1Extra-temporal lobe epilepsySeizure onset regionEEG recordingsExtra-temporal originResection correlatesSurgical resectionLobe epilepsyPoor outcomePrognostic valueClinical significanceBetter outcomesPatientsSeizuresEpileptic networkOnset zoneDifferent anatomical regionsEpilepsy databaseTwo‐year seizure reduction in adults with medically intractable partial onset epilepsy treated with responsive neurostimulation: Final results of the RNS System Pivotal trial
Heck CN, King‐Stephens D, Massey AD, Nair DR, Jobst BC, Barkley GL, Salanova V, Cole AJ, Smith MC, Gwinn RP, Skidmore C, Van Ness PC, Bergey GK, Park YD, Miller I, Geller E, Rutecki PA, Zimmerman R, Spencer DC, Goldman A, Edwards JC, Leiphart JW, Wharen RE, Fessler J, Fountain NB, Worrell GA, Gross RE, Eisenschenk S, Duckrow RB, Hirsch LJ, Bazil C, O'Donovan CA, Sun FT, Courtney TA, Seale CG, Morrell MJ. Two‐year seizure reduction in adults with medically intractable partial onset epilepsy treated with responsive neurostimulation: Final results of the RNS System Pivotal trial. Epilepsia 2014, 55: 432-441. PMID: 24621228, PMCID: PMC4233950, DOI: 10.1111/epi.12534.Peer-Reviewed Original ResearchConceptsIntractable partial-onset seizuresPartial-onset seizuresOpen-label periodResponsive stimulationSeizure focusSeizure reductionOnset seizuresSham stimulationIntractable partial onset epilepsySerious adverse event ratesFocal cortical stimulationPartial-onset epilepsyAdverse event ratesFrequency of seizuresMedian percent reductionAdditional treatment optionsSham stimulation groupBlinded periodMonth postimplantAdjunctive therapyAdverse eventsOnset epilepsyPivotal trialsCortical stimulationTreatment options
2008
Temporal distributions of seizure occurrence from various epileptogenic regions
Durazzo TS, Spencer SS, Duckrow RB, Novotny EJ, Spencer DD, Zaveri HP. Temporal distributions of seizure occurrence from various epileptogenic regions. Neurology 2008, 70: 1265-1271. PMID: 18391158, DOI: 10.1212/01.wnl.0000308938.84918.3f.Peer-Reviewed Original ResearchConceptsMesial temporal lobeSeizure occurrencePartial epilepsyTemporal lobeBrain regionsParietal seizuresSeizure distributionNeocortical temporal lobeParietal lobe seizuresTemporal lobe seizuresFrontal lobe seizuresConsecutive adult subjectsCortical brain regionsCircadian rhythmNeocortical temporalSurgical resectionTemporal seizuresIntracranial EEG recordingsEpileptogenic regionSeizuresAdult subjectsEpilepsyEndogenous circadian rhythmLobeEEG recordings