Application of Surgery in Epilepsy

A special issue of Brain Sciences (ISSN 2076-3425). This special issue belongs to the section "Neurosurgery and Neuroanatomy".

Deadline for manuscript submissions: closed (15 January 2025) | Viewed by 2205

Special Issue Editors


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Guest Editor
1. Neurosurgery, University of Pennsylvania, Philadelphia, PA 19104, USA
2. Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
Interests: neurosurgery; epilepsy; brain tumor; movement disorders; spasticity

E-Mail Website
Guest Editor
Doctor of Medicine, Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA 19104, USA
Interests: epilepsy surgery; pediatrics; ECoG signal processing

Special Issue Information

Dear Colleagues,

The surgical management of epilepsy is an ever-broadening field with intense controversies and new treatments that are already both commonplace and being utilized with widely different strategies from institution to institution. In this Special Issue, we aim to amplify recent developments in these treatments, insights from clinical experience, translational or relevant basic science research, or thorough reviews not recently covered elsewhere.

A large proportion of patients with drug-resistant epilepsy have multifocal, generalized, eloquent-onset, or broad onset epilepsy, and are poor candidates for traditional resective surgery. Beyond a ketogenic diet and vagus nerve stimulation, intracranial neuromodulation had demonstrated great promise and has become a rapidly growing field unto itself. Although early studies demonstrated the proof of principle that it is often effective, a wide range of stimulation strategies, targets, stimulation parameters, and technical nuances are currently being explored individually by many institutions. We encourage these strategies to be reported here.

The lessons learned from using temporarily or permanently implanted electrodes can give us remarkable insights into both epilepsy and cognition, and with the vast number of such electrodes implanted every day, we continue to be fascinated by these research experiences.

Reports on outcomes from all types of epilepsy surgery are similarly encouraged for submission to this Special Issue.

Sincerely,

Dr. Benjamin C. Kennedy
Dr. Samuel Tomlinson
Guest Editors

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Keywords

  • epilepsy surgery
  • neuromodulation
  • drug-resistant epilepsy
  • sEEG
  • DBS
  • RNS
  • LITT

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Published Papers (1 paper)

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Review

12 pages, 262 KiB  
Review
Overcoming Graft Rejection in Induced Pluripotent Stem Cell-Derived Inhibitory Interneurons for Drug-Resistant Epilepsy
by Cameron P. Beaudreault, Richard Wang, Carrie Rebecca Muh, Ashley Rosenberg, Abigail Funari, Patty E. McGoldrick, Steven M. Wolf, Ariel Sacknovitz and Sangmi Chung
Brain Sci. 2024, 14(10), 1027; https://doi.org/10.3390/brainsci14101027 - 16 Oct 2024
Viewed by 1866
Abstract
Background: Cell-based therapies for drug-resistant epilepsy using induced pluripotent stem cell-derived inhibitory interneurons are now in early-phase clinical trials, building on findings from trials in Parkinson’s disease (PD) and Huntington’s disease (HD). Graft rejection and the need for immunosuppressive therapy post-transplantation pose potential [...] Read more.
Background: Cell-based therapies for drug-resistant epilepsy using induced pluripotent stem cell-derived inhibitory interneurons are now in early-phase clinical trials, building on findings from trials in Parkinson’s disease (PD) and Huntington’s disease (HD). Graft rejection and the need for immunosuppressive therapy post-transplantation pose potential barriers to more epilepsy patients becoming potential candidates for inhibitory interneurons transplantation surgery. Objectives: The present literature review weighs the evidence for and against human leukocyte antigen (HLA)-mediated graft rejection in PD and HD and examines the potential advantages and drawbacks to five broad approaches to cell-based therapies, including autologous cell culture and transplantation, in vivo reprogramming of glial cells using viral vectors, allogeneic transplantation using off-the-shelf cell lines, transplantation using inhibitory interneurons cultured from HLA-matched cell lines, and the use of hypoimmunogenic-induced pluripotent stem cell-derived inhibitory interneurons. The impact of surgical technique and associated needle trauma on graft rejection is also discussed. Methods: Non-systematic literature review. Results: While cell-based therapies have enjoyed early successes in treating a host of central nervous system disorders, the immunologic reaction against surgical procedures and implanted materials has remained a major obstacle. Conclusions: Adapting cell-based therapies using iPSC-derived inhibitory interneurons for epilepsy surgery will similarly require surmounting the challenge of immunogenicity. Full article
(This article belongs to the Special Issue Application of Surgery in Epilepsy)
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