Epilepsi Nöbetlerinde Derin Beyin Stimülasyonun Yeri
Özet
Epilepsi hastalarının yaklaşık %30'unun medikal tedaviye direnç göstermesi, derin beyin stimülasyonu (DBS) gibi cerrahi yöntemlerin önemini artırmaktadır. Bu tedavi yöntemi; anterior talamik nükleus, hipokampus ve sentromedian nükleus gibi stratejik noktaların elektriksel uyarımıyla nörolojik aktiviteyi düzenleyerek nöbet sıklığını azaltmayı hedefler. Özellikle fokal ve dirençli nöbetlerde güvenli bir seçenek sunan DBS, hastaların yaşam kalitesini artırırken teknolojik gelişmeler ve biyomühendislik çalışmalarıyla gelecekte daha yaygın bir kullanım potansiyeli taşımaktadır.
Approximately 30% of epilepsy patients are resistant to medical treatment, which increases the importance of surgical methods such as deep brain stimulation (DBS). This treatment method aims to reduce seizure frequency by regulating neurological activity through electrical stimulation of strategic points such as the anterior thalamic nucleus, hippocampus, and centromedian nucleus. Providing a safe option especially for focal and refractory seizures, DBS improves the quality of life of patients and holds the potential for more widespread use in the future with technological developments and bioengineering studies.
Referanslar
Fiest KM, Sauro KM, Wiebe S,: Prevalence and incidence of epilepsy: a systematic review and meta-analysis of international studies. Neurology 88:296–303, 20
Kwan P, Brodie MJ: Early identification of refractory epilepsy. N Engl J Med 342:314–319, 2000 27.
Kwan P, Sperling MR: Refractory seizures: try additional antiepileptic drugs (after two have failed) or go directly to early surgery evaluation? Epilepsia 50 (Suppl 8):57–62, 2009
Sander JW: The epidemiology of epilepsy revisited. Curr Opin Neurol 16:165–170, 2003
Choi H, Sell RL, Lenert L, (2008) Epilepsy surgery for pharmacoresistant temporal lobe epilepsy: a decision analysis. JAMA 300:2497–2505. doi:10. 1001/jama.2008.771
Engel J Jr, Wiebe S, French J (2003) Practice parameter: temporal lobe and localized neocortical resections for epilepsy: report of the Quality Standards Subcommittee of the American Academy of Neurology, in association with the American Epilepsy Society and the American Association of Neurological Surgeons. Neurology 60:538–547
Labiner DM, Bagic AI, Herman ST, , National Association of Epilepsy Centers (2010) Essential services, personnel, and facilities in specialized epilepsy centers—revised 2010 guidelines. Epilepsia 51:2322–2333. doi: 10.1111/j.1528-1167.2010.02648.x
Schmidt D, Stavem K: Long-term seizure outcome of surgery versus no surgery for drug-resistant partial epilepsy: a review of controlled studies. Epilepsia 50:1301–1309, 2009
Jobst BC, Cascino GD: Resective epilepsy surgery for drugresistant focal epilepsy: a review. JAMA 313:285–293, 2015
Englot DJ, Raygor KP, Molinaro AM, (2014) Factors associated with failed focal neocortical epilepsy surgery. Neurosurgery 75:648–656. doi:10. 1227/NEU.0000000000000530
Englot DJ, Rolston JD, Wang DD, (2013) Seizure outcomes after temporal lobectomy in pediatric patients. J Neurosurg Pediatr 12:134–141. doi:10.3171/2013.5. PEDS12526
Engel J Jr, McDermott MP, Wiebe S (2012) Early surgical therapy for drugresistant temporal lobe epilepsy: a randomized trial. JAMA 307: 922–930. doi:10.1001/jama.2012.220
Upton AR, Cooper IS, Springman M, Suppression of seizures and psychosis of limbic system origin by chronic stimulation of anterior nucleus of the thalamus. Int J Neurol 19-20:223–230, 1985–1986
Cooper IS, Amin I, Gilman S: The effect of chronic cerebellar stimulation upon epilepsy in man. Trans Am Neurol Assoc 98:192–196, 1973
Kowski AB, Voges J, Heinze HJ,: Nucleus accumbens stimulation in partial epilepsy—a randomized controlled case series. Epilepsia 56:e78–e82, 2015
Krishna V, King NK, Sammartino F: Anterior nucleus deep brain stimulation for refractory epilepsy: insights into patterns of seizure control and efficacious target. Neuros
McIntyre CC, Savasta M, Kerkerian-Le Goff L,: Uncovering the mechanism(s) of action of deep brain stimulation: activation, inhibition, or both. Clin Neurophysiol 115:1239–1248, 2004
Mirski MA, Rossell LA, Terry JB: Anticonvulsant effect of anterior thalamic high frequency electrical stimulation in the rat. Epilepsy Res 28:89–100, 19
Akman T, Erken H, Acar G; Effects of the hippocampal deep brain stimulation on cortical epileptic discharges in penicillin—induced epilepsy model in rats. Turk Neurosurg 21:1–5, 2011
Neil Klinger, Sandeep Mittal, Deep brain stimulation for seizure control in drug-resistant epilepsy Neurosurg Focus 45 (2):E4, 2018
Buckner RL: The cerebellum and cognitive function: 25 years of insight from anatomy and neuroimaging. Neuron 80:807–815, 2013
Cooke PM, Snider RS (1955) Some cerebellar influences on electrically induced cerebral seizures. Epilepsia 4:19–28
Van Buren JM, Wood JH, Oakley J: Preliminary evaluation of cerebellar stimulation by double-blind stimulation and biological criteria in the treatment of epilepsy. J Neurosurg 48:407–416, 1978
Bidziński J, Bacia T, Ostrowski K: [Effect of cerebellar cortical electrostimulation on the frequency of epileptic seizures in severe forms of epilepsy.] Neurol Neurochir Pol 15:605–609, 1981 (Polish)
Velasco F, Carrillo-Ruiz JD, Brito F: Double-blind, randomized controlled pilot study of bilateral cerebellar stimulation for treatment of intractable motor seizures. Epilepsia 46:1071–1081, 2005
Kim SH, Lim SC, Kim J: Longterm follow-up of anterior thalamic deep brain stimulation in epilepsy: a 11-year, single center experience. Seizure 52:154– 161, 2017
Han CL, Hu W, Stead M, (2014) Electrical stimulation of hippocampus for the treatment of refractory temporal lobe epilepsy. Brain Res Bull 109:13–21. doi:10.1016/j.brainresbull.2014.08.007
Boon P, Vonck K, De Herdt V: Deep brain stimulation in patients with refractory temporal lobe epilepsy. Epilepsia 48:1551–1560, 2007
Velasco AL, Velasco F, Velasco M, Electrical stimulation of the hippocampal epileptic foci for seizure control: a double-blind, long-term follow-up study. Epilepsia 48:1895–1903, 2007
Tellez-Zenteno JF, McLachlan RS, Parrent ;Hippocampal electrical stimulation in mesial temporal lobe epilepsy. Neurology 66:1490–1494, 2000
Saalmann YB: Intralaminar and medial thalamic influence on cortical synchrony, information transmission and cognition. Front Syst Neurosci 8:83, 2014
Velasco AL, Velasco F, Jimenez F (2006) Neuromodulation of the centromedian thalamic nuclei in the treatment of generalized seizures and the improvement of the quality of life in patients with Lennox-Gastaut syndrome. Epilepsia 47:1203–1212. doi:10.1111/ j.1528-1167.2006.00593.x
Fisher RS, Uematsu S, Krauss GL: Placebo-controlled pilot study of centromedian thalamic stimulation in treatment of intractable seizures. Epilepsia 33:841–851, 1992
Parent A, Hazrati LN: Functional anatomy of the basal ganglia. II. The place of subthalamic nucleus and external pallidum in basal ganglia circuitry. Brain Res Brain Res Rev 20:128–154, 1995
Lewis EC, Weil AG, Duchowny M, Bhatia S (2015) MR-guided laser interstitial thermal therapy for pediatric drug-resistant lesional epilepsy. Epilepsia 56:1590–1598. doi:10. 1111/epi.13106
Chabardès S, Kahane P, Minotti L: Deep brain stimulation in epilepsy with particular reference to the subthalamic nucleus. Epileptic Disord 4 (Suppl 3):S83–S93, 2002
Wille C, Steinhoff BJ, Altenmuller DM,(2011) Chronic high-frequency deep-brain stimulation in progressive myoclonic epilepsy in adulthood—report of five cases. Epilepsia 52:489–496. doi:10.1111/j.1528-1167.2010.02884.x
FDA (2013) Device approvals and clearances. Accessed 30 March 2013
Fisher R, Salanova V, Witt T (2010) Electrical Neurosurg Rev stimulation of the anterior nucleus of thalamus for treatment of refractory epilepsy. Epilepsia 51:899–908. doi:10.1111/j.1528- 1167.2010.02536.x
Morrell MJ: Responsive cortical stimulation for the treatment of medically intractable partial epilepsy. Neurology 77:1295–1304, 2011
Coley E, Farhadi R, Lewis S :The incidence of seizures following deep brain stimulating electrode implantation for movement disorders, pain and psychiatric conditions. Br J Neurosurg 23:179–183, 2009
Pouratian N, Reames DL, Frysinger R: Comprehensive analysis of risk factors for seizures after deep brain stimulation surgery. Clinical article. J Neurosurg 115:310– 315, 2011
Chabardes S, Isnard S, Castrioto A: Surgical implantation of STN-DBS leads using intraoperative MRI guidance: technique, accuracy, and clinical benefit at 1-year follow-up. Acta Neurochir (Wien) 157:729–737, 2015
Giller CA, Liu H, German DC: A stereotactic near-infrared probe for localization during functional neurosurgical procedures: further experience. J Neurosurg 110:263–273, 2009