title: Manipulating the epileptic brain using stimulation: a review of experimental and clinical studies.
abstract: Neurostimulation represents an interesting alternative therapy for patients resistant to drug treatment or who cannot benefit from resective surgery. Theoretically, neurostimulation allows the control of seizures to be tailored to the individual patient and specific form of epilepsy. Here, we review both experimental and clinical studies that have reported the possible control of epileptic seizures by means of different approaches using electrical stimulation (vagus nerve stimulation, deep brain stimulation and repetitive transcranial magnetic stimulation). The rationale for targeting specific areas that have thus far been considered (i.e., vagus nerve, cerebellum, anterior or centromedial thalamus, basal ganglia, cortex and temporal lobe) is addressed in the light of experimental data and clinical effectiveness in different models and forms of epilepsy. The type of seizures that can be considered for neurostimulation, as well as the optimal parameters such as stimulation frequency and modes of stimulation (chronic, continuous or adaptative), are discussed to determine the best candidates for such a therapeutic strategy. This review points out the need for improved knowledge of neural circuits that generate seizures and/or allow their propagation, as well as a better understanding of the mechanisms of action of neurostimulation.
authors.affiliation: Institut des Neurosciences, INSERM U836-UJF-CEA, Grenoble, France.
authors.forename: Sandrine
authors.initials: S
authors.lastname: Saillet
authors.forename: Mélanie
authors.initials: M
authors.lastname: Langlois
authors.forename: Berend
authors.initials: B
authors.lastname: Feddersen
authors.forename: Lorella
authors.initials: L
authors.lastname: Minotti
authors.forename: Laurent
authors.initials: L
authors.lastname: Vercueil
authors.forename: Stephan
authors.initials: S
authors.lastname: Chabardès
authors.forename: Olivier
authors.initials: O
authors.lastname: David
authors.forename: Antoine
authors.initials: A
authors.lastname: Depaulis
authors.forename: Colin
authors.initials: C
authors.lastname: Deransart
authors.forename: Philippe
authors.initials: P
authors.lastname: Kahane
mesh_terms: D000818:Animals; D001479:Basal Ganglia / Q000503:physiopathology / Q000601:surgery; D001921:Brain / Q000503:physiopathology* / Q000601:surgery*; D002531:Cerebellum / Q000503:physiopathology / Q000601:surgery; D046690:Deep Brain Stimulation / Q000379:methods*; D004827:Epilepsy / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D013788:Thalamus / Q000503:physiopathology / Q000601:surgery; D050781:Transcranial Magnetic Stimulation / Q000379:methods*; D016896:Treatment Outcome; D055536:Vagus Nerve Stimulation / Q000379:methods*