ArticleBrain : a journal of neurology2024
Closed-loop stimulation in periods with less epileptiform activity drives improved epilepsy outcomes.
Article in Brain : a journal of neurology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers.
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Who cites it
40 citing papers in PubMed.
- Early assessment of responsive neurostimulation for drug-resistant epilepsy in China: A multicenter, self-controlled study.Chinese medical journal · 2025Trial
- Implant-Grade Neural Sensing with Artifact-Resilient Computational Intelligence Preserves Spatial Fidelity of HFO Biomarkers in Epilepsy.Research square · 2026Article
- A guide to neuromodulation in drug-resistant epilepsy.Epileptic disorders : international epilepsy journal with videotape · 2026Review
- Advancing data protections for implantable brain-computer interfaces.Communications medicine · 2026Review
- The use of quantitative electroencephalography in evaluating epilepsy treatment.Acta epileptologica · 2026Review
- Clusters in Thalamic iEEG Spectral Features Reveal Sleep/Wake Differences Over Time.Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society · 2026Article
- Nucleus-specific thalamic involvement in seizure networks differentiates neuromodulation outcomes.medRxiv : the preprint server for health sciences · 2026Article
- Virtual Responsive Neurostimulation Implantation: From Intracranial Connectivity to Optimized Lead Placement.medRxiv : the preprint server for health sciences · 2026Article
- An artefact-resilient wide bandwidth bidirectional graphene neural interface.Nature communications · 2026Article
- Review
- Responsive neurostimulation in children, adolescents, and young Adults-Longitudinal effectiveness and safety.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2026Article
- Pathway to Adaptive Neuromodulation: Modeling Epileptogenic Brain States Using SEEG.Epilepsy currents · 2026Article
- sEEG-guided responsive neurostimulation to treat neocortical epilepsy: A multicenter retrospective study of the efficacy and safety of depth electrode-mediated neuromodulation.Epilepsia open · 2026Article
- The Palliative Nature of Pediatric Epilepsy Surgery and Our Procedures.Pediatric neurosurgery · 2026Review
- Proceedings of the 13th annual deep brain stimulation think tank: the evolving landscape.Frontiers in human neuroscience · 2026Review
- Dataset of chronic intracranial EEG of epilepsy patients via responsive neurostimulation system.Frontiers in neuroscience · 2026Article
- Collapse of interictal suppressive networks permits seizure spread.Brain : a journal of neurology · 2025Article
- A clinical grade neurostimulation implant for hierarchical control of physiological activity.bioRxiv : the preprint server for biology · 2025Article
- Interneuron theta phase locking controls seizure susceptibility.bioRxiv : the preprint server for biology · 2025Article
- Interictal network dysfunction and cognitive impairment in epilepsy.Nature reviews. Neuroscience · 2025Review
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
In patients with drug-resistant epilepsy, electrical stimulation of the brain in response to epileptiform activity can make seizures less frequent and debilitating. This therapy, known as closed-loop responsive neurostimulation (RNS), aims to directly halt seizure activity via targeted stimulation of a burgeoning seizure. Rather than immediately stopping seizures as they start, many RNS implants produce slower, long-lasting changes in brain dynamics that better predict clinical outcomes. Here we hypothesize that stimulation during brain states with less epileptiform activity drives long-term changes that restore healthy brain networks. To test this, we quantified stimulation episodes during low- and high-risk brain states-that is, stimulation during periods with a lower or higher risk of generating epileptiform activity-in a cohort of 40 patients treated with RNS. More frequent stimulation in tonic low-risk states and out of rhythmic high-risk states predicted seizure reduction. Additionally, stimulation events were more likely to be phase-locked to prolonged episodes of abnormal activity for intermediate and poor responders when compared to super-responders, consistent with the hypothesis that improved outcomes are driven by stimulation during low-risk states. These results support the hypothesis that stimulation during low-risk periods might underlie the mechanisms of RNS, suggesting a relationship between temporal patterns of neuromodulation and plasticity that facilitates long-term seizure reduction.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.