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Nerve-Stimulation Treatment Proves Effective Against Drug-Resistant Epilepsy
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http://news.yahoo.com/non-invasive-magnetic-coil-applying-deep-brain-stimulation-132208698.html
Nerve-Stimulation Treatment Proves Effective Against Drug-Resistant Epilepsy
Medications are the mainstay of treatment for epilepsy, but for a considerable number of patients estimated to be as many as 1 million in the U.S. drugs don't work. These patients suffer from a type of epilepsy known as refractory or drug-resistant epilepsy, in which drugs can't control their seizures.
But at an epilepsy conference last month, Dr. Christopher DeGiorgio, a UCLA professor of neurology, presented the results of a non-invasive, non-pharmaceutical treatment that shows promise in controlling seizures.
In his talk at the Antiepileptic Drug Trials XI Conference in Miami, Fla., DeGiorgio reported the results of a Phase 2 clinical trial of a new treatment called trigeminal nerve stimulation (TNS). He noted that 40 percent of the patients receiving TNS treatment experienced a significant improvement in seizure reduction.
The external stimulator, which is about the size of a large cell phone, attaches to a belt or can slip into a pocket. Wires from the stimulator are passed under the clothing and connected to conductive pads attached to the forehead. The electrodes, which can be covered by a cap or scarf, transmit a signal to the trigeminal nerve, which extends into the brain from the face and forehead and is known to play a role in seizure inhibition.
"TNS offers potential benefits it can be delivered bilaterally (to both sides of the brain) and at high frequencies," DeGiorgio said. "Since the electrical energy does not travel directly into the brain, TNS provides a safe method of brain modulation."
The clinical trial showed that at the end of the 18-week study, 40 percent of patients receiving TNS experienced a significant improvement in seizure reduction, which is defined as a 50 percent or greater decrease in the frequency of seizures.
"We showed that TNS works well, under stringent clinical-trial conditions. The fact that 40 percent showed a clinically-meaningful response is exciting," DeGiorgio said.
These results confirm and extend the findings of DeGiorgio's positive Phase 1 trial in epilepsy, reported in 2009 in the journal Neurology.
In addition, the researchers found that the TNS treatment also improved the mood of the participants. Since depression is a common problem in people with epilepsy, this finding could have significant impact on the quality of life of people who suffer from the disorder.
DeGiorgio, lead inventor of TNS, was the principal investigator for the Phase 2 study, which was conducted at Olive View UCLA Medical Center and the University of Southern California.
"I'm encouraged to see that our non-invasive and safe approach to neuromodulation compares favorably to pharmaceutical and surgically implanted device therapies of drug-resistant epilepsy," he said.
Source: University of California, Los Angeles (UCLA)
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http://news.yahoo.com/non-invasive-magnetic-coil-applying-deep-brain-stimulation-132208698.htmlWASHINGTON, Aug. 18, 2011 /PRNewswire-USNewswire/ -- The Epilepsy Therapy Project (ETP) and the Epilepsy Foundation (EF) announced today a New Therapy Grant to potentially help those with treatment resistant epilepsy. This grant was awarded to Alexander Rotenberg, M.D., Ph.D., Assistant Professor of Neurology, Children's Hospital Boston, and will support a clinical study to evaluate the repetitive transcranial magnetic stimulation (rTMS) H-Coil as a promising non-invasive method of inhibiting the abnormal electrical activity believed to underlie seizures in focal temporal lobe epilepsy (TLE). Seizures originating in this part of the brain are often difficult to treat and resistant to existing therapies.
"Temporal lobe epilepsy accounts for nearly 20 percent of all epilepsy and an estimated 70 percent of drug resistant focal epilepsy cases. rTMS is a new therapeutic intervention of immediate importance to patients with poor seizure control," said Dr. Rotenberg. "This award will speed the development of this approach to deep brain stimulation to treat temporal lobe epilepsy."
Dr. Rotenberg's program is based upon the premise that seizures may be managed by applying deep magnetic stimulation delivered around the head by the H-Coil technology to areas of the brain such as the temporal lobe, an area where many seizures start. The rTMS technology is approved for use in the treatment of major depression and other neuropsychiatric syndromes in Europe and Israel and marketed by Brainsway Ltd.
rTMS for Treatment of Temporal Lobe Epilepsy
Repetitive transcranial magnetic stimulation is a safe and painless method for focal brain stimulation, where small electrical currents inside the brain are induced by a powerful fluctuating magnetic field from outside the brain. Previous testing of low frequency rTMS did reduce brain excitability and suppressed seizures in some patients, but not in patients with TLE. However, the H-Coil's stronger effect penetrates into deeper brain regions.
Dr. Rotenberg and his research team hypothesize that rTMS with the H-Coil, designed to generate sufficient magnetic field strength, can safely and effectively stimulate deeper brain structures and may inhibit the electrical and neurotransmitter activity that underlies seizures in TLE. Their hypothesis is based in part on the encouraging antiepileptic effect of conventional rTMS in other types of epilepsy, and on their animal studies which showed that deeper brain stimulation by rTMS can suppress seizures in rats. The New Therapy Grant will support a clinical study of the H-Coil in children and adults with intractable TLE.
If this study shows the expected effect in seizure control, the H-Coil could rapidly move to commercialization for TLE treatment because a different version of the H-Coil that targets other deep brain areas is already marketed for treatment of major depression and other neuropsychiatric syndromes.
The New Therapy Grants Program is a unique joint venture between two non-profit epilepsy organizations, The Epilepsy Therapy Project and the Epilepsy Foundation. Grants are awarded to support programs that demonstrate promise as new treatments through critical early clinical milestones and readiness for further investment and development. Applications are evaluated by scientific and business advisory board members including experienced clinicians, scientists, investors and pharmaceutical and device industry executives. Awards are given based on the potential to provide substantial benefit in a timeframe relevant to those living with epilepsy today. To date, more than 45 grants have been awarded for the advancement of new therapeutics and devices that have demonstrated a more rapid path to benefitting patients and future commercialization.
"We regard the New Therapy Grants Program as an engine to accelerate the development of the most promising new epilepsy therapies, especially approaches with near-term promise to improve the lives of those with epilepsy," said Warren Lammert, chairman of the Epilepsy Therapy Project. "We believe the H-Coil, with proven safety and efficacy in other medical conditions, may have direct applicability to epilepsy. We are pleased to provide critical clinical support that may advance this device towards proof of concept and late-stage evaluation."
"This innovative cutting edge study underscores the missions of our two organizations," said Rich Denness, president & CEO of the Epilepsy Foundation. "This kind of translational research transforms scientific concepts into real treatments for real people and can help eliminate seizures and improve the quality of life for people living with epilepsy."
http://news.yahoo.com/non-invasive-magnetic-coil-applying-deep-brain-stimulation-132208698.html
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