Dartmouth Medical School, Hanover, New Hampshire, USA.
Epilepsia. 2010 Jul;51 Suppl 3:88-92. doi: 10.1111/j.1528-1167.2010.02618.x.
Direct brain stimulation is an emerging treatment of epilepsy. Scheduled or responsive stimulation has been applied. The most explored targets for scheduled stimulation are the anterior nucleus of the thalamus and the hippocampus. The anterior nucleus of the thalamus was studied in a large multicenter trial. There was a significant seizure reduction with the stimulator "on" versus "off" during several months after stimulator implantation. The hippocampus as stimulation target has not yet been studied in a large randomized trial. Responsive stimulation applies a stimulus whenever epileptiform activity occurs. It requires on-line detection of epileptiform activity. This concept is based on the observation that epileptiform activity during functional mapping can be aborted by brief pulses of cortical stimulation. Current technology is able to detect seizure activity intracranially on-line and delivers a high frequency stimulus if epileptiform activity is detected. A large randomized multicenter trial has been conducted testing this system for focal epilepsy.
直接脑刺激是一种新兴的癫痫治疗方法。已应用计划刺激或反应性刺激。计划刺激最常探索的靶点是丘脑前核和海马体。在前核丘脑的研究在一个大型多中心试验中。在刺激器植入后几个月，“开”与“关”相比，癫痫发作显著减少。作为刺激靶点的海马体尚未在大型随机试验中进行研究。反应性刺激在出现癫痫样活动时施加刺激。它需要在线检测癫痫样活动。这一概念基于这样的观察，即在功能映射过程中出现的癫痫样活动可以通过短暂的皮质刺激脉冲来终止。当前的技术能够在线检测颅内的癫痫发作活动，如果检测到癫痫样活动，就会发出高频刺激。一项大型的多中心随机试验已经对该系统进行了测试，以评估其对局部癫痫的疗效。
