Epilepsy is a disorder of the brain characterized by an enduring predisposition to generate epileptic seizures and by the associated comorbidities such as cognitive, psychological, and social consequences of this condition. Up to 30 percent of patients with epilepsy are pharmacoresistant. Apart from those candidates for resective surgery, most will continue to have disabling seizures and a wide range of cognitive and psychiatric symptoms. Recurrent seizures and comorbidities in epilepsy impair patients’ health-related quality of life. Comorbidities and epilepsy have a bidirectional relationship, sharing common underlying pathogenesis. Until now, no conventional antiepileptic drugs commonly used are proven to play a solid role in preventing epileptogenesis or epilepsy-related comorbidities. Therefore, it is critical to develop a novel therapeutic approach with the potential to benefit patients with pharmacoresistant epilepsy.
Neuromodulation, such as vagus nerve stimulation (VNS), deep brain stimulation (DBS), or closed-loop responsive neurostimulation (RNS), have been extensively used in treating patients with pharmacoresistant epilepsy. In the primarily palliative approaches, only a few individuals have achieved complete freedom from seizures for more than 12 months with these therapies, whereas more than half have benefited from a long-term reduction in seizure frequency of more than 50%. In addition, VNS/DBS, after some time, clearly induces long-lasting changes in the neuronal network involved in epilepsy, which indicate that neuromodulation is a promising disease-modifying therapy for epilepsy. Despite the mechanisms underlying the neuromodulation is still overall unclear, there is increasing evidence that the neuromodulation likely involves a combination of multiple mechanisms to inhibit seizures, postpone disease progression as well as attenuate the epilepsy associated comorbidities.
In this Research Topic, we wish to cover, but are not limited to, the following:
- Efficacy of neuromodulation in pharmacoresistant epilepsy
- Neuromodulation and comorbidities associated with epilepsy
- Biomarkers to predict response to neuromodulation therapies
- Neuromodulation and sudden unexpected death in epilepsy (SUDEP)
- Potential mechanism of neuromodulation in treating epilepsy
Contributors are encouraged to submit original submissions in basic science and clinical investigations, which have the potential to advance the field significantly. In addition to original research papers, we welcome the review articles covering novel insights into mechanisms mobilized by neuromodulation therapies. All papers contributed to the field will be subjected to rigorous peer review.
Epilepsy is a disorder of the brain characterized by an enduring predisposition to generate epileptic seizures and by the associated comorbidities such as cognitive, psychological, and social consequences of this condition. Up to 30 percent of patients with epilepsy are pharmacoresistant. Apart from those candidates for resective surgery, most will continue to have disabling seizures and a wide range of cognitive and psychiatric symptoms. Recurrent seizures and comorbidities in epilepsy impair patients’ health-related quality of life. Comorbidities and epilepsy have a bidirectional relationship, sharing common underlying pathogenesis. Until now, no conventional antiepileptic drugs commonly used are proven to play a solid role in preventing epileptogenesis or epilepsy-related comorbidities. Therefore, it is critical to develop a novel therapeutic approach with the potential to benefit patients with pharmacoresistant epilepsy.
Neuromodulation, such as vagus nerve stimulation (VNS), deep brain stimulation (DBS), or closed-loop responsive neurostimulation (RNS), have been extensively used in treating patients with pharmacoresistant epilepsy. In the primarily palliative approaches, only a few individuals have achieved complete freedom from seizures for more than 12 months with these therapies, whereas more than half have benefited from a long-term reduction in seizure frequency of more than 50%. In addition, VNS/DBS, after some time, clearly induces long-lasting changes in the neuronal network involved in epilepsy, which indicate that neuromodulation is a promising disease-modifying therapy for epilepsy. Despite the mechanisms underlying the neuromodulation is still overall unclear, there is increasing evidence that the neuromodulation likely involves a combination of multiple mechanisms to inhibit seizures, postpone disease progression as well as attenuate the epilepsy associated comorbidities.
In this Research Topic, we wish to cover, but are not limited to, the following:
- Efficacy of neuromodulation in pharmacoresistant epilepsy
- Neuromodulation and comorbidities associated with epilepsy
- Biomarkers to predict response to neuromodulation therapies
- Neuromodulation and sudden unexpected death in epilepsy (SUDEP)
- Potential mechanism of neuromodulation in treating epilepsy
Contributors are encouraged to submit original submissions in basic science and clinical investigations, which have the potential to advance the field significantly. In addition to original research papers, we welcome the review articles covering novel insights into mechanisms mobilized by neuromodulation therapies. All papers contributed to the field will be subjected to rigorous peer review.