title: Adaptive control of epileptiform excitability in an in vitro model of limbic seizures.
abstract: Deep brain stimulation (DBS) is a promising tool for treating drug-resistant epileptic patients. Currently, the most common approach is fixed-frequency stimulation (periodic pacing) by means of stimulating devices that operate under open-loop control. However, a drawback of this DBS strategy is the impossibility of tailoring a personalized treatment, which also limits the optimization of the stimulating apparatus. Here, we propose a novel DBS methodology based on a closed-loop control strategy, developed by exploiting statistical machine learning techniques, in which stimulation parameters are adapted to the current neural activity thus allowing for seizure suppression that is fine-tuned on the individual scale (adaptive stimulation). By means of field potential recording from adult rat hippocampus-entorhinal cortex (EC) slices treated with the convulsant drug 4-aminopyridine we determined the effectiveness of this approach compared to low-frequency periodic pacing, and found that the closed-loop stimulation strategy: (i) has similar efficacy as low-frequency periodic pacing in suppressing ictal-like events but (ii) is more efficient than periodic pacing in that it requires less electrical pulses. We also provide evidence that the closed-loop stimulation strategy can alternatively be employed to tune the frequency of a periodic pacing strategy. Our findings indicate that the adaptive stimulation strategy may represent a novel, promising approach to DBS for individually-tailored epilepsy treatment.
authors: Montreal Neurological Institute, Department of Neurology & Neurosurgery, McGill University, 3801 University Street, Montreal, QC, Canada H3A 2B4.
authors: Gabriella
authors: G
authors: Panuccio
authors: Arthur
authors: A
authors: Guez
authors: Robert
authors: R
authors: Vincent
authors: Massimo
authors: M
authors: Avoli
authors: Joelle
authors: J
authors: Pineau
mesh_terms: D000222:Adaptation, Physiological / Q000502:physiology*; D000818:Animals; D001703:Biophysics; D004558:Electric Stimulation / Q000009:adverse effects; D005071:Evoked Potentials / Q000502:physiology*; D066298:In Vitro Techniques; D008032:Limbic System / Q000502:physiology*; D009434:Neural Pathways / Q000502:physiology; D051381:Rats; D017207:Rats, Sprague-Dawley