Description
- Abstract:
- "Epilepsy impacts 1-2% of the worldwide population, with one-third having drug resistant epilepsy (DRE) Neuromodulations such as deep brain stimulation(DBS), responsive neurostimulation(RNS), and vagus nerve stimulation(VNS) have become a significant treatment approach for these patients, although limited accessibility and many other factors influence the treatment results and unstable results is still challenging. This review aims to analyze the mechanisms, clinical outcomes associated with DBS, RNS, VNS in patients with DRE emphasizing recent advances and potential strategies for enhancing therapeutic outcomes A search was conducted in google scholar, pubmed and scopus. For articles published between 2020-2025 using the key words ""drug resistant epilepsy"", ""deep brain stimulation"", ""vagus nerve stirnulation"" and ""neurostimulation"". Studies were included if they focused on how DBS, VINS, RNS contributed to improving the prognosis in patients with DRE and were excluded if they were published before 2020 and if they focused only on pharmacological, surgical treatmerits without neuromodulation. Amongst 237,895 US patients with DRE, only 2.1% received DBS or RNS. Structural imaging reveals compromised thalamocortical integrity with DRE, with increased fractional anisotropy in thalamus prefrontal and thalamus temporal pathways express improved VNS response. Clinical VNS studies showed a decrease in seizures in about 50% of the patients, better outcomes are observed in cases with shorter epilepsy duration. Meta-analysis of t VNS RCTs show significant decrease in seizure frequency and less side effects. DBS researchers marked the ideal seizure management that occurs with the frequency stimulation (100-130 Hz) by regulating cortical synchrony and GABAergic tone. Neuromodulation is a fast-evolving technology in the management of DRE. Despite challenges like healthcare disparities, differences in neural integrity raising evidence shows. that personalized stimulation and biomarker guided therapy can improve patient outcome. With constant innovation and collaboration, neuromodulations offer potential of transforming the prognosis and quality of these patients."
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Citation
Hari Alekhya, Sanya Singh, Varun Dwivedi, Pragati Pande, Mansi Pillay,
"Advances of Neuromodulation for Drug-Resistant Epilepsy: From Mechanisms to Clinical Outcomes"
(2025).
Student Neurosurgery/Neurology Research Conference.
Brown Digital Repository. Brown University Library.
https://doi.org/10.26300/8fcv-pk92
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Student Neurosurgery/Neurology Research Conference
Brown University Department of Neurosurgery and Department of Neurology and Warren Alpert Medical School annually hosts the Student Neurosurgery/Neurology Research Conference, a national conference for medical students conducting research in neurosurgery/neurology or related neuroscience fields....