PMID- 33962250
OWN - NLM
STAT- MEDLINE
DCOM- 20210629
LR  - 20220716
IS  - 1525-5069 (Electronic)
IS  - 1525-5050 (Print)
IS  - 1525-5050 (Linking)
VI  - 120
DP  - 2021 Jul
TI  - Cortical responsive neurostimulation in a baboon with genetic generalized 
      epilepsy.
PG  - 107973
LID - S1525-5050(21)00207-9 [pii]
LID - 10.1016/j.yebeh.2021.107973 [doi]
AB  - OBJECTIVE: To evaluate the efficacy of cortical responsive neurostimulation (CRN) 
      in a male baboon with epilepsy and with genetic generalized epilepsy (GGE), as 
      well as the alteration of seizure patterns and their circadian rhythms due to 
      treatment. METHODS: The baboon was implanted with two subdural frontoparietal 
      strips, bridging the medial central sulci bilaterally. Electrocorticography 
      (ECoG) data were downloaded daily during a three-month baseline, then every 
      2-3 days over a five-month treatment period. Long episodes, reflecting ictal or 
      interictal epileptic discharges, were also quantified. RESULTS: Twenty-three 
      generalized tonic-clonic seizures (GTCS) and 2 episodes of nonconvulsive status 
      epilepticus (NCSE) were recorded at baseline (median 8 events/month), whereas 26 
      GTCS were recorded under treatment (median 5/month). Similarly, daily indices of 
      long episodes decreased from 0.46 at baseline to 0.29 with treatment. Ictal ECoG 
      patterns and the circadian distribution of GTCS were also altered by RNS therapy. 
      SIGNIFICANCE: This case study provides the proof-of-concept for RNS therapy in 
      the baboon model of GGE. Cortical responsive neurostimulation (CRN) demonstrated 
      a 38% median reduction in GTCS. Distinct ictal patterns were identified, which 
      changed over the treatment period; the circadian pattern of his GTCS also shifted 
      gradually from night to daytime with treatment. Future studies targeting the 
      thalamic nuclei, or combining cortical and subcortical sites, may further improve 
      detection and control of GTCS as well as other generalized seizure types. More 
      broadly, this study demonstrates opportunities for evaluating seizure detection 
      as well as chronic therapeutic interventions over long term in the baboon.
CI  - Copyright (c) 2021 Elsevier Inc. All rights reserved.
FAU - Akos Szabo, C
AU  - Akos Szabo C
AD  - Department of Neurology, UT Health San Antonio, San Antonio, TX, United States. 
      Electronic address: szabo@uthscsa.edu.
FAU - De La Garza, Melissa
AU  - De La Garza M
AD  - Southwest National Primate Research Center, Texas Biomedical Research Institute, 
      San Antonio, TX, United States.
FAU - Shade, Robert
AU  - Shade R
AD  - Southwest National Primate Research Center, Texas Biomedical Research Institute, 
      San Antonio, TX, United States.
FAU - Papanastassiou, Alexander M
AU  - Papanastassiou AM
AD  - Department of Neurosurgery, UT Health San Antonio, San Antonio, TX, United 
      States.
FAU - Nathanielsz, Peter
AU  - Nathanielsz P
AD  - Southwest National Primate Research Center, Texas Biomedical Research Institute, 
      San Antonio, TX, United States; Department of Animal Science, University of 
      Wyoming, Laramie, WY, United States.
LA  - eng
GR  - C06 RR013556/RR/NCRR NIH HHS/United States
GR  - C06 RR015456/RR/NCRR NIH HHS/United States
GR  - P51 RR013986/RR/NCRR NIH HHS/United States
GR  - P51 OD011133/OD/NIH HHS/United States
GR  - C06 RR014578/RR/NCRR NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20210504
PL  - United States
TA  - Epilepsy Behav
JT  - Epilepsy & behavior : E&B
JID - 100892858
SB  - IM
MH  - Animals
MH  - Electroencephalography
MH  - *Epilepsy
MH  - *Epilepsy, Generalized
MH  - Humans
MH  - Male
MH  - Papio
MH  - Seizures
MH  - *Status Epilepticus
PMC - PMC8483259
MID - NIHMS1735550
OTO - NOTNLM
OT  - Baboon
OT  - Circadian rhythms
OT  - Generalized tonic-clonic seizures
OT  - Genetic generalized epilepsy
OT  - Responsive neurostimulation therapy
COIS- Declaration of Competing Interest: The authors have nothing to declare.
EDAT- 2021/05/08 06:00
MHDA- 2021/06/30 06:00
PMCR- 2022/07/01
CRDT- 2021/05/07 20:32
PHST- 2021/01/25 00:00 [received]
PHST- 2021/03/25 00:00 [revised]
PHST- 2021/04/01 00:00 [accepted]
PHST- 2021/05/08 06:00 [pubmed]
PHST- 2021/06/30 06:00 [medline]
PHST- 2021/05/07 20:32 [entrez]
PHST- 2022/07/01 00:00 [pmc-release]
AID - S1525-5050(21)00207-9 [pii]
AID - 10.1016/j.yebeh.2021.107973 [doi]
PST - ppublish
SO  - Epilepsy Behav. 2021 Jul;120:107973. doi: 10.1016/j.yebeh.2021.107973. Epub 2021 
      May 4.