NeuroPace, Inc, Mountain View, CA, USA.
Neurology & Neurological Sciences, Stanford University, Stanford Neuroscience Health Center, Palo Alto, CA, USA.
Expert Rev Med Devices. 2021 Feb;18(2):129-138. doi: 10.1080/17434440.2019.1683445. Epub 2020 Sep 16.
: Epilepsy affects more than 1% of the US population, and over 30% of adults with epilepsy do not respond to antiseizure medications without life-impacting medication-related side effects. Resection of the seizure focus is not an option for many patients because it would cause unacceptable neurological or cognitive harm. For these patients, neuromodulation has emerged as a nondestructive, effective, and safe alternative. The NeuroPace® RNS® System, the only brain-responsive neurostimulation device, records neural activity from leads placed at one or two seizure foci. When the neurostimulator detects epileptiform activity, as defined for each patient by his or her physician, brief pulses of electrical stimulation are delivered to normalize the activity.: This review describes the RNS System, the results of multi-year clinical trials, and the research discoveries enabled by the chronic ambulatory brain data collected by the RNS System.: Brain-responsive neurostimulation could potentially be used to treat any episodic neurological disorder that's accompanied by a neurophysiological biomarker of severity. Combining advanced machine learning approaches with the chronic ambulatory brain data collected by the RNS System could eventually enable automatic fine-tuning of detection and stimulation for each patient, creating a general-purpose neurotechnological platform for precision medicine.
癫痫影响了美国超过 1%的人口，超过 30%的癫痫成年人在没有生活影响的药物相关副作用的情况下对抗癫痫药物没有反应。由于切除致痫灶会导致不可接受的神经或认知损害，因此许多患者无法选择这种方法。对于这些患者，神经调节已成为一种非破坏性、有效且安全的替代方法。NeuroPace®RNS®系统是唯一具有大脑反应能力的神经刺激器，可从一个或两个致痫灶放置的导联记录神经活动。当神经刺激器检测到癫痫样活动时（由每位患者的医生定义），会向大脑发送短暂的电脉冲刺激，以使其恢复正常。本文介绍了 RNS 系统、多年临床试验结果，以及 RNS 系统收集的慢性可移动大脑数据所带来的研究发现。大脑反应性神经刺激有可能用于治疗任何伴有严重神经生理生物标志物的发作性神经障碍。将先进的机器学习方法与 RNS 系统收集的慢性可移动大脑数据相结合，最终可以实现为每位患者自动调整检测和刺激，从而为精准医疗创建一个通用的神经技术平台。
