Can neuromodulation reduce the excitability of neurons and therefore reduce seizures in epilepsy patients? That is the question that scientists at the University of California Los Angeles (UCLA) Semel Institute are asking.

UCLA logo 250Along with Principal Investigator and neurologist Dr. John Stern, UCLA researchers Alexander Bystritsky and Alex Korb have been awarded a partial grant from the Friedman Foundation to use the BrainSonix neuromodulation system to treat 12 patients with pharmacologically refractory temporal lobe epilepsy (TLE), the most common form of epilepsy. TLE can be effectively treated by temporal lobe surgery; however, surgery does not always eliminate seizures, and many patients are not suitable candidates for the procedure.

BrainSonix received FDA approval to their low-intensity focused ultrasound pulsation (LIFUP) device to noninvasively treat TLE. The study aims to:
  • the safety and feasibility of the LIFUP device
  • determine whether FUS can be used to stimulate or suppress brain activity in patients with epilepsy
  • the hypothesis that FUS brain stimulation or suppression will be visible with fMRI
Patients who are interested in this study can find complete information on www.clinicaltrials.gov.

Treatment Alternatives
No noninvasive treatment alternatives currently exist to treat medically refractive patients with TLE. Vagus nerve stimulation (VNS), responsive neurostimulation (RNS), and deep brain stimulation (DBS) are treatments that all require neurosurgery. Repetitive transcranial magnetic stimulation (rTMS) cannot be focused in three dimensions, so it is limited to superficial areas of the brain. Laser ablation (Visualase) is a minimally invasive option.

The Advantages of LIFUP
LIFUP:
  • is noninvasive
  • can be highly focused in three dimensions
  • has the ability to precisely modulate region-specific brain activity

Scientists are hoping that these features translate into a treatment option that is safe, long-lasting, and effective for suppressing epileptic seizures.

Previous Studies
Preclinical studies found the transcranial neuromodulatory effects of LIFUP to be effective without causing tissue damage. One study conducted at Brigham and Women’s Hospital found that LIFUP sonication could suppress regional cortical activity. More significantly, LIFUP temporarily suppressed seizures/seizure activity without tissue damage.

Treatment Effect
Suppressing seizure activity does not cure epilepsy, but its researchers theorize that repeated LIFUP use may have a long-term, cumulative effect similar to how TMS is used in treating depression. LIFUP could also potentially be used to map epileptogenic areas of the brain.

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