Epilepsy Stimulation Device Detects Other Brain Disorders

(Gordon Johnson, Pixabay)

3 Jan. 2019. An implanted device that stimulates areas of the brain associated with seizures can detect other neurological diseases in people with epilepsy. A team from University of Alabama in Birmingham reported its findings last month in the journal Epilepsy and Behavior (paid subscription required).

Researchers led by Birmingham neurology professor Sandipan Pati are seeking better methods for treating brain disorders that occur in people with epilepsy, but are often difficult to detect. Epilepsy is a neurological disorder where nerve cell activity in the brain is disturbed, causing seizures with symptoms ranging from blank stares to tingling sensations to loss of consciousness. World Health Organization estimates some 50 million people worldwide have epilepsy, where in many cultures people with the condition face stigma and discrimination.

The authors note that an unmet need of people with epilepsy is the occurrence of other neuropsychiatric conditions, such as  anxiety, depression, and psychosis. “Treating these patients can be challenging,” says Pati in a university statement, “and one reason for this is that sometime seizures can mimic anxiety and panic attacks, or psychosis.” The team investigated data from an implanted device as a tool for detecting these additional disorders.

The researchers studied the records of 21 individuals with epilepsy resistant to conventional drugs, who have a Responsive Neurostimulator System device surgically implanted in their brains. The device is made by NeuroPace Inc. in Mountain View, California that detects impending signals of a seizure, then sends electronic impulses to two areas of the brain associated with the onset of seizures. Patients can also start the device manually when they sense the onset of a seizure. The Responsive Neurostimulator System records brain activity during these sessions, with the data downloaded to an external system, such as a doctor’s laptop, for further analysis.

Pati and colleagues reanalyzed the records of the 21 individuals, particularly the electronic signals data collected by the Responsive Neurostimulator Systems. Their analysis revealed five of the individuals — nearly one in four of the total — showed symptoms of other neuropsychiatric conditions, such as panic attacks and psychosis. The devices also indicated cases of conversion disorder, blindness or paralysis not explained by conventional medical evaluations, and somatic disorders, where patients focus intensely on pain or fatigue, causing emotional distress.

The five individuals in the study found with these other neuropsychiatric conditions received drug treatment, cognitive behavioral therapy, or counseling to address the issues revealed by the implanted devices, and according to the authors, saw improvements in their conditions.

The results suggest that these neurostimulation devices can provide actionable evidence for physicians treating people with epilepsy that was not previously available. “Seizure-induced anxiety or psychosis is treated with anti-seizure medications,” notes Pati, “while ‘pure’ psychosis is treated with anti-psychotic medications. This study will be attractive for patients, as anxiety or depression is a common problem in epilepsy, and patients get frustrated as they think we are always focused on treating seizures and not depression.”

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