Implantable device designed to detect, stop seizures under study at MCG

August 20, 2004

A small electronic device implanted in the skull that detects oncoming seizures then delivers a brief electrical stimulus to the brain to stop them is under study at the Medical College of Georgia.

MCG is among some dozen U.S. centers participating in a study to determine if the neurostimulator device can help patients whose seizures are not well controlled by drugs.

"We really want another option for treating patients who are not effectively helped by existing treatments," says Dr. Anthony Murro, neurologist, epileptologist and a principal investigator on the study. "If this works out, it could represent a new way of treating epilepsy that is unlike drug treatment where people live with the side effects of drugs they take every day to prevent seizures."

"If this works as well as we hope it works, it could absolutely revolutionize epilepsy surgery," says Dr. Joseph Smith, MCG neurosurgeon specializing in stereotactic and functional surgery. Dr. Smith, who has performed epilepsy surgery at MCG Medical Center since 1985, says if the study proves the device is effective, he can see patients preferring the new approach to today's standard that often includes removing areas of the brain where abnormal electrical activity originates, called the seizure focus.

At MCG Medical Center, the device will be used in about 20 patients age 18-65 who have not gotten their seizures controlled on at least two medications and have at least four seizures per month; seizure activity is closely monitored through a diary and monthly doctor visits for three months before patients are eligible.

"We use the patient's seizure pattern which we recorded long before surgery to develop the parameters we use to detect future seizures," Dr. Smith says. During the procedure he creates a form-fitting defect for the device in the skull near the seizure focus and uses tiny screws to hold it securely in place. Once he implants the device, up to two electrodes are placed within the brain near the seizure focus. Afterward, a modified laptop computer is used to look at electrical activity picked up by the neurostimulator and to program the device to recognize the patient's seizure activity. If the neurostimulator detects abnormal activity, it sends an electrical stimulus to stop it, a stimulus that appears to go unnoticed by patients, the doctors say. Study patients will be followed for about two years to assess how well the device works.

MCG doctors already have used it as a temporary measure to try and stop seizures in 15 patients whose seizure activity already was being monitored. In one patient with frequent seizures, they were able to compare seizure activity with and without the stimulation in an effort to further analyze its contribution to stopping seizures. The experience prompted the MCG doctors to want to study the implantable device.

Doctors already have experience using electrical activity to help control seizures. A pacemaker-like device called the vagus nerve stimulator has been used for about six years that regularly electrically stimulates the vagal nerve in the neck, sending signals to the brain. The vagus nerve stimulator has helped reduce seizure frequency but is unlikely to make many patients seizure-free. "If they still have a seizure, even just one every several months, most patients still have trouble driving, getting and keeping a job and living a normal life," Dr. Murro says. "So the goal is to stop all seizures."

They also have years of experience using electrical stimulation in the brain, including deep brain stimulation which uses high-frequency stimulation to inhibit overactive areas of the brain involved in movement in patients with Parkinson's disease.

About 1 in 200 people have seizures and about 1 out of 3 cannot get their seizures under control with one or more medications. Some patients also are not candidates for traditional epilepsy surgery where the seizure focus is removed because the location of the focus increases the risk of resulting problems or deficits. "This device may be a major help for those patients, I think," Dr. Smith says.

He and Dr. Murro also agree that if the implantable neurostimulator is proven to be safe and effective it may benefit many epilepsy patients in the future. "We would expect that hospitalization and risk of complication would be much less than that of traditional epilepsy surgery," Dr. Murro says.

As with other epilepsy surgery, they also hope this new approach will provide a lifelong solution, requiring only battery replacement.

For more information about the study, call Dr. Patty Ray, study coordinator, at 706-721-6260.

Medical College of Georgia at Augusta University

Related Brain Articles from Brightsurf:

Glioblastoma nanomedicine crosses into brain in mice, eradicates recurring brain cancer
A new synthetic protein nanoparticle capable of slipping past the nearly impermeable blood-brain barrier in mice could deliver cancer-killing drugs directly to malignant brain tumors, new research from the University of Michigan shows.

Children with asymptomatic brain bleeds as newborns show normal brain development at age 2
A study by UNC researchers finds that neurodevelopmental scores and gray matter volumes at age two years did not differ between children who had MRI-confirmed asymptomatic subdural hemorrhages when they were neonates, compared to children with no history of subdural hemorrhage.

New model of human brain 'conversations' could inform research on brain disease, cognition
A team of Indiana University neuroscientists has built a new model of human brain networks that sheds light on how the brain functions.

Human brain size gene triggers bigger brain in monkeys
Dresden and Japanese researchers show that a human-specific gene causes a larger neocortex in the common marmoset, a non-human primate.

Unique insight into development of the human brain: Model of the early embryonic brain
Stem cell researchers from the University of Copenhagen have designed a model of an early embryonic brain.

An optical brain-to-brain interface supports information exchange for locomotion control
Chinese researchers established an optical BtBI that supports rapid information transmission for precise locomotion control, thus providing a proof-of-principle demonstration of fast BtBI for real-time behavioral control.

Transplanting human nerve cells into a mouse brain reveals how they wire into brain circuits
A team of researchers led by Pierre Vanderhaeghen and Vincent Bonin (VIB-KU Leuven, Université libre de Bruxelles and NERF) showed how human nerve cells can develop at their own pace, and form highly precise connections with the surrounding mouse brain cells.

Brain scans reveal how the human brain compensates when one hemisphere is removed
Researchers studying six adults who had one of their brain hemispheres removed during childhood to reduce epileptic seizures found that the remaining half of the brain formed unusually strong connections between different functional brain networks, which potentially help the body to function as if the brain were intact.

Alcohol byproduct contributes to brain chemistry changes in specific brain regions
Study of mouse models provides clear implications for new targets to treat alcohol use disorder and fetal alcohol syndrome.

Scientists predict the areas of the brain to stimulate transitions between different brain states
Using a computer model of the brain, Gustavo Deco, director of the Center for Brain and Cognition, and Josephine Cruzat, a member of his team, together with a group of international collaborators, have developed an innovative method published in Proceedings of the National Academy of Sciences on Sept.

Read More: Brain News and Brain Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to