Approximately 2.3 million adults in the United States have epilepsy. Most of these people are able to control their epilepsy with drugs, but approximately 1/3 of those afflicted are not helped by epilepsy drugs. Brain surgery to extract the part of the brain responsible for epilepsy can relieve seizures completely, but surgery is only an option if the seizures are coming from one or two specific places in the brain, and if those parts can be removed. If seizures are being caused by the parts of the brain that are essential, such as those related to memory and language, surgery is not an option. Approximately 400,000 have cases which fall into this category.
But, help to some of them is on the way! According to a New York Times article in this week’s Science Times, the Food and Drug Administration has just approved a device, called the RNS System, which is implanted into the brain, and helps reduce the frequency of epilepsy. It consists of a battery-powered stimulator which is implanted in the skull, with connections to the relevant areas of the brain. The RNS System senses and records electrical activity in the brain, and responds by delivering an electric stimulation to the parts of the brain related to epilepsy, so as to interrupt brain activity before the seizures happen.
The RNS is a huge step forward in the treatment of epilepsy. According to the FDA, in the clinical study for the system, patients with the device turned on experienced a 38 percent reduction in the average number of seizures per month. This shows at once its efficacy and its limitations. The RNS will clearly be a huge help to some patients, but not as much for others. Still, it brings hope to the many epileptics who have been struggling for years with their ailment.-JE
This is an awesome step forward in the use of small computers to treat disease. Have they identified what might be limiting the effectiveness of the implant? Is it imprecision in targeting seizure locations or some other issue? The mechanics of a seizure are really fascinating as the near infinite number of connections in the brain can cause positive feedback loops when not inhibited properly, hopefully devices like this one will get better at interfering with those feedback loops and treating the disease.
ReplyDelete-Stephen O'Brien
Great question! The limits of the implant are related to the details of the patient. The implant works best when there are only one or two problem areas which consistently cause the seizures. The implant is in a sense a learning system, in that it is able to detect the electrical circuitry of the brain, and sort out patterns. But if there is no one unique place that the seizures are coming from, the contraption is not as useful, because it doesn't know which part of the brain to shock preemptively before the seizure happens.
Delete-JE
This was a very interesting read. I did not know that about 2.3 million adults have epilepsy in United States. That's a lot higher than I thought! The brain is such a tough area of the body to understand and work with. This new development is exciting! Has the implant been tested on many patients? How many of them have been successful?
ReplyDeletePosted by Amber Vien
The implant has had a major clinical study done, in which they found that 38% of the people given the device and had it turned on experienced significant improvement. However, interestingly enough, a control was also part of the study; they gave some people the device and did not turn it on, to measure the placebo effect of the device. They found that 17% experienced significant improvement. So perhaps only 21% of people who get better get better actually due to the device!
Delete-JE
This is absolutely a great invention. Do you know if it is affordable for most of the patients? 38 percent may not sound very effective but to epilepsy patients, it could be one of the best things can happen. Even though it is approved by FDA, I still feel like having devices implanted in human brain is dangerous due to possible short circuit.
ReplyDelete-Yim Hui
The RNS costs $40,000, and the cost of surgery and consultation before hand could be around $20,000. This is something most people could not afford on their own, but the New York Times reports that most of the costs insurance companies are willing to pay for. This is because the device reduces the total hospitalizations an epileptic patient needs, thereby reducing the cost to the insurance company in the long term for that patient.
Delete-JE
38 percent might seem like a small number, but in actuality this is huge. This is FDA approved and offers relief to patients who were once told they are not eligible for surgery or do not find relief through medication. I'm sure its gone through countless trials and clinics before being approved for this level and I believe further research on this idea could prove to be very efficacious.
ReplyDeleteMax Liner
Wow this is very interesting. Do you know why the success rate is only 38%? Of course this is still a great advancement, but are there modifications that can be made to the device to improve this percentage? Also are there any negative side effects to having this device implanted into your brain?
ReplyDeleteposted by kristen whitehead
Reading stuff like this definitly has me excited for the future and the possible new tech we can create. One question I have is what are the specific spots one could operate on in the brain? Why only these spots?
ReplyDeletePosted by Jacob Geier