Experimental neurology
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There is increased interest in neurostimulation as a treatment for drug-resistant epilepsy. Two large pivotal trials have recently been completed, one using bilateral anterior thalamic stimulation and another employing closed loop responsive therapy of the brain. These are potential additions to the therapeutic options for neurostimulation in addition to already approved vagus nerve stimulation. This review will address the principles of the various types of neurostimulation, the results of the pivotal trials and the important considerations for interpreting the results of these trials which differ from trials of antiepileptic drugs.
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Experimental neurology · Jun 2013
Impaired recruitment of seizure-generated neurons into functional memory networks of the adult dentate gyrus following long-term amygdala kindling.
Epileptic seizures increase the birth of new neurons in the adult hippocampus. Although the consequences of aberrant neurogenesis on behavior are not fully understood, one hypothesis is that seizure-generated neurons might form faulty circuits that disrupt hippocampal functions, such as learning and memory. In the present study, we employed long-term amygdala kindling (i.e., rats receive 99-electrical stimulations) to examine the effect of repeated seizures on hippocampal neurogenesis and behavior. ⋯ Moreover, long-term kindling also prevented the activation of 4-week old newborn cells in response to fear memory retrieval. These results indicate that the presence of seizure activity during cell maturation impedes the ability of new neurons to integrate properly into circuits important in memory formation. Together, our findings suggest that aberrant seizure-induced neurogenesis might contribute to the development of learning impairments in chronic epilepsy and raise the possibility that targeting the reduced activation of adult born neurons could represent a beneficial strategy to reverse cognitive deficits in some epileptic patients.