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Brain Sci. 2018, 8(4), 69; https://doi.org/10.3390/brainsci8040069

Epilepsy and Neuromodulation—Randomized Controlled Trials

1
Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
2
Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
3
Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
4
St. George’s Medical School, St. George, Grenada
5
Department of Neurosurgery, Oxford University, John Radcliffe Hospital, Oxford OX3 9DU, UK
*
Author to whom correspondence should be addressed.
Received: 19 March 2018 / Revised: 5 April 2018 / Accepted: 16 April 2018 / Published: 18 April 2018
(This article belongs to the Special Issue Diagnosis and Surgical Treatment of Epilepsy)
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Abstract

Neuromodulation is a treatment strategy that is increasingly being utilized in those suffering from drug-resistant epilepsy who are not appropriate for resective surgery. The number of double-blinded RCTs demonstrating the efficacy of neurostimulation in persons with epilepsy is increasing. Although reductions in seizure frequency is common in these trials, obtaining seizure freedom is rare. Invasive neuromodulation procedures (DBS, VNS, and RNS) have been approved as therapeutic measures. However, further investigations are necessary to delineate effective targeting, minimize side effects that are related to chronic implantation and to improve the cost effectiveness of these devices. The RCTs of non-invasive modes of neuromodulation whilst showing much promise (tDCS, eTNS, rTMS), require larger powered studies as well as studies that focus at better targeting techniques. We provide a review of double-blinded randomized clinical trials that have been conducted for neuromodulation in epilepsy. View Full-Text
Keywords: epilepsy; neuromodulation; randomized clinical trials (RCT); deep brain stimulation (DBS); transcranial direct current stimulation (tDCS); vagal nerve stimulation (VNS); external trigeminal nerve stimulation (eTNS); repetitive transcranial magnetic stimulation (rTMS); responsive neurostimulation (RNS) epilepsy; neuromodulation; randomized clinical trials (RCT); deep brain stimulation (DBS); transcranial direct current stimulation (tDCS); vagal nerve stimulation (VNS); external trigeminal nerve stimulation (eTNS); repetitive transcranial magnetic stimulation (rTMS); responsive neurostimulation (RNS)
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).
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Kwon, C.-S.; Ripa, V.; Al-Awar, O.; Panov, F.; Ghatan, S.; Jetté, N. Epilepsy and Neuromodulation—Randomized Controlled Trials. Brain Sci. 2018, 8, 69.

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