Mogul David J, van Drongelen Wim
Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, Illinois 60616; email:
Annu Rev Biomed Eng. 2014 Jul 11;16:483-504. doi: 10.1146/annurev-bioeng-071813-104720.
Epilepsy afflicts approximately 1-2% of the world's population. The mainstay therapy for treating the chronic recurrent seizures that are emblematic of epilepsy are drugs that manipulate levels of neuronal excitability in the brain. However, approximately one-third of all epilepsy patients get little to no clinical relief from this therapeutic regimen. The use of electrical stimulation in many forms to treat drug-refractory epilepsy has grown markedly over the past few decades, with some devices and protocols being increasingly used as standard clinical treatment. This article seeks to review the fundamental modes of applying electrical stimulation-from the noninvasive to the nominally invasive to deep brain stimulation-for the control of seizures in epileptic patients. Therapeutic practices from the commonly deployed clinically to the experimental are discussed to provide an overview of the innovative neural engineering approaches being explored to treat this difficult disease.
癫痫折磨着全球约1%-2%的人口。治疗癫痫所特有的慢性复发性癫痫发作的主要疗法是通过药物来调节大脑中神经元的兴奋性水平。然而,所有癫痫患者中约有三分之一从这种治疗方案中几乎没有得到临床缓解。在过去几十年里,多种形式的电刺激用于治疗药物难治性癫痫的应用显著增加,一些设备和方案越来越多地被用作标准临床治疗方法。本文旨在综述应用电刺激的基本模式——从非侵入性到名义上的侵入性再到深部脑刺激——以控制癫痫患者的癫痫发作。文中讨论了从常用的临床实践到实验性实践,以概述为治疗这种疑难疾病而探索的创新神经工程方法。