Researchers at Mayo Clinic have developed a new personalized approach for deep brain stimulation (DBS) for people with drug-resistant epilepsy. The new method is based on mapping the unique patterns of each patient's brain waves to pinpoint the exact area of the thalamus where stimulation is most effective against seizures. This research is part of Mayo Clinic's BIONIC (Bioelectronic Innovation for Neural Oscillation Curative) initiative, which combines clinical knowledge with cutting-edge engineering to offer innovative diagnostics and therapies. Physician-scientists at Mayo Clinic are now tailoring the treatment to each individual's seizure network before the DBS device is implanted. "Our unique approach aims to adapt neuromodulation for each patient," says Nick Gregg, M.D., a neurologist at Mayo Clinic and lead author of an article published in Annals of Neurology. By mapping the unique patterns of each patient's brain waves, the method allows physicians to pinpoint the exact area of the brain where stimulation proves most effective, thus overcoming the traditional "one-size-fits-all" approach. DBS involves implanting electrodes into the brain to deliver electrical impulses that help prevent and control seizures. Since seizures occur infrequently, doctors analyze irregular brain wave patterns that signal abnormal activity. "We are trying to interrupt the pathological hypersynchrony and reduce the excitability of the network to decrease the risk of seizure," says Dr. Gregg. Ten patients received this personalized approach while being evaluated for epilepsy surgery. Although effective, DBS is often administered with electrodes placed in the same brain region in most patients. The next phase of the research will follow those who have received permanent DBS implants using this personalized approach. "The long-term goal is to silence the seizure network until it is, over time, forgotten. "We are moving beyond the one-size-fits-all approach to an individualized approach that maximizes interaction with the seizure network to better modulate abnormal brain wave activity." Once the researchers identify the specific area of the thalamus—a small relay center located deep in the brain—that connects to the patient's seizure network, they can fine-tune the stimulation parameters for that individual.
