More research into deep brain stimulation (DBS) has shown that the positive effects in epilepsy are long lasting. The latest results show a 69 per cent average reduction in seizure frequency five years after the DBS device was implanted.
DBS is a treatment that involves a stimulating electrode being implanted in the brain. This stimulates specific areas deep in the brain to prevent seizures. It has been used to treat Parkinson’s disease for many years, but is still rarely used to treat epilepsy.
The DBS device has been approved in Europe and Canada, but not in the US. Vicenta Salanova MD is a professor of neurology and director of the Indiana University School of Medicine Comprehensive Epilepsy Program. According to Prof Salanova, it is hoped that this will soon change. She said: “We hope that based on the results we have shown – that there is continuous improvement – that the device will eventually be approved in the US.”
The latest results are from the ongoing Stimulation of the Anterior Nucleus of Thalamus for Epilepsy (SANTE) trial. They show an average reduction of 40 per cent in seizure frequency after three months of stimulation. This improvement continued to 41 per cent after one year, 56 per cent after two years and 69 per cent after five years.
The SANTE results also show that people had improvements in quality of life, and had no unexpected side-effects.
Paul Boon MD (Department of Neurology, Ghent University Hospital, Belgium) said that the results are encouraging. He states that they contribute to “evidence that stimulating nucleus actually affects epileptogenic networks”.
However, further research is needed to increase the number of people who can have a device implanted. He continues: “I can’t foresee that in 10 years all patients will have an anterior nucleus deep brain stimulation as we perform it right now.”
A clinical trial is being organised between two European centres to test hippocampal DBS. Researchers will test the effects in people with unmanageable temporal lobe epilepsy. It is hoped that the results will contribute to DBS being approved by the US Food and Drug Administration in the near future.