Brief review of deep brain stimulation anticonvulsant mechanisms in epilepsy

Document Type : Systematic Review

Authors
1 Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
2 Department of Biophysics, Institute of Biophysics and Biochemistry, University of Tehran, Tehran, Iran
Abstract
Deep Brain Stimulation (DBS) has been developed as a new therapeutic manner for the treatment of neurological disorders, offering a reversible and adjustable alternative to traditional lesion-based surgeries. By delivering targeted electrical stimulation to specific brain regions, DBS modulates neural circuits and restores dysfunctional networks. Beyond its established role in movement disorders like Parkinson’s disease, DBS has shown remarkable efficacy in managing epilepsy. Its therapeutic effects are mediated through complex mechanisms, including neurotransmitter modulation, ion channel regulation, and alterations in the brain’s microenvironment. This article explores how DBS leverages these multifaceted processes to revolutionize neuromodulation and offers insights into its expanding potential for treating epilepsy.

Keywords: Deep Brain Stimulation, Epilepsy, Anticonvulsant, Seizure

Keywords

Subjects


1. Brown RG, Limousin Dowsey P, Brown P, Jahanshahi M, Pollak P, Benabid AL, et al. Impact of deep brain stimulation on upper limb akinesia in Parkinson’s disease. Ann Neurol. 1999 Apr;45(4):473–88.
2. Schuepbach WMM, Rau J, Knudsen K, Volkmann J, Krack P, Timmermann L, et al. Neurostimulation for Parkinson’s Disease with Early Motor Complications. N Engl J Med. 2013 Feb 14;368(7):610–22.
3. Hubble JP, Busenbark KL, Wilkinson S, Penn RD, Lyons K, Koller WC. Deep brain stimulation for essential tremor. Neurology. 1996 Apr;46(4):1150–3.
4. Kumar R, Dagher A, Hutchison WD, Lang AE, Lozano AM. Globus pallidus deep brain stimulation for generalized dystonia: Clinical and PET investigation. Neurology. 1999 Sep;53(4):871–871.
5. Fisher R, Salanova V, Witt T, Worth R, Henry T, Gross R, et al. Electrical stimulation of the anterior nucleus of thalamus for treatment of refractory epilepsy. Epilepsia. 2010 May;51(5):899–908.
6. Greenberg BD, Malone DA, Friehs GM, Rezai AR, Kubu CS, Malloy PF, et al. Three-Year Outcomes in Deep Brain Stimulation for Highly Resistant Obsessive–Compulsive Disorder. Neuropsychopharmacol. 2006 Nov 1;31(11):2384–93.
7. Hassler R. Sagittal thalamotomy for relief of motor disorders in cases of double athetosis and cerebral palsy. Confin Neurol. 1972;34(2):18–28.
8. Spiegel EA, Wycis HT. Thalamotomy and pallidotomy for treatment of choreic movements. Acta neurochir. 1952 Sep;2(3–4):417–22.
9. Winn HR, Youmans JR, editors. Youmans and Winn neurological surgery: fully, searchable text online. 7th-8th edition ed. Philadelphia, PA: Elsevier; 2017.
10. Meissner W, Leblois A, Hansel D, Bioulac B, Gross CE, Benazzouz A, et al. Subthalamic high frequency stimulation resets subthalamic firing and reduces abnormal oscillations. Brain. 2005 Oct 1;128(10):2372–82.
11. McIntyre CC, Anderson RW. Deep brain stimulation mechanisms: the control of network activity via neurochemistry modulation. Journal of Neurochemistry. 2016 Oct;139(S1):338–45.
12. Dostrovsky JO, Lozano AM. Mechanisms of deep brain stimulation. Mov Disord. 2002 Mar;17(S3):S63–8.
13. Gubellini P, Salin P, Kerkerian-Le Goff L, Baunez C. Deep brain stimulation in neurological diseases and experimental models: From molecule to complex behavior. Progress in Neurobiology. 2009 Sep;89(1):79–123.
14. Lozano AM, Lipsman N. Probing and Regulating Dysfunctional Circuits Using Deep Brain Stimulation. Neuron. 2013 Feb;77(3):406–24.
15. Ziai WC, Sherman DL, Bhardwaj A, Zhang N, Keyl PM, Mirski MA. Target‐specific Catecholamine Elevation Induced by Anticonvulsant Thalamic Deep Brain Stimulation. Epilepsia. 2005 Jun;46(6):878–88.
16. Mirski MA, Rossell LA, Terry JB, Fisher RS. Anticonvulsant effect of anterior thalamic high frequency electrical stimulation in the rat. Epilepsy Research. 1997 Sep;28(2):89–100.
17. Covolan L, Motta Pollo ML, Dos Santos PB, Betta VHC, Saad Barbosa FF, Covolan LAM, et al. Effects and mechanisms of anterior thalamus nucleus deep brain stimulation for epilepsy: A scoping review of preclinical studies. Neuropharmacology. 2024 Dec;260:110137.
18. Tseng HT, Hsiao YT, Yi PL, Chang FC. Deep Brain Stimulation Increases Seizure Threshold by Altering REM Sleep and Delta Powers During NREM Sleep. Front Neurol. 2020 Aug 12;11:752.
19. Shojaee A, Zareian P, Mirnajafi-Zadeh J. Low-frequency Stimulation Decreases Hyperexcitability Through Adenosine A1 Receptors in the Hippocampus of Kindled Rats. Basic Clin Neurosci J. 2020 May 30;333–48.
20. Xiong Z, Deng J, Xie P, Tang C, Wang J, Deng Q, et al. Deep Brain Stimulation Inhibits Epileptic Seizures via Increase of Adenosine Release and Inhibition of ENT1, CD39, and CD73 Expression. Mol Neurobiol [Internet]. 2024 Jul 23 [cited 2025 Jan 7]; Available from: https://link.springer.com/10.1007/s12035-024-04374-3
21. Wang F, Xin M, Li X, Li L, Wang C, Dai L, et al. Effects of deep brain stimulation on dopamine D2 receptor binding in patients with treatment-refractory depression. Journal of Affective Disorders. 2024 Jul;356:672–80.
22. Yuen J, Goyal A, Rusheen AE, Kouzani AZ, Berk M, Kim JH, et al. High frequency deep brain stimulation can mitigate the acute effects of cocaine administration on tonic dopamine levels in the rat nucleus accumbens. Front Neurosci. 2023 Jan 30;17:1061578.
23. Rezaei M, Raoufy MR, Fathollahi Y, Shojaei A, Mirnajafi-Zadeh J. Tonic and phasic stimulations of ventral tegmental area have opposite effects on pentylenetetrazol kindled seizures in mice. Epilepsy Research. 2023 Jan;189:107073.
24. Figee M, De Koning P, Klaassen S, Vulink N, Mantione M, Van Den Munckhof P, et al. Deep Brain Stimulation Induces Striatal Dopamine Release in Obsessive-Compulsive Disorder. Biological Psychiatry. 2014 Apr;75(8):647–52.
25. Ashouri Vajari D, Ramanathan C, Tong Y, Stieglitz T, Coenen VA, Döbrössy MD. Medial forebrain bundle DBS differentially modulates dopamine release in the nucleus accumbens in a rodent model of depression. Experimental Neurology. 2020 May;327:113224.
26. Ranck JB. Which elements are excited in electrical stimulation of mammalian central nervous system: A review. Brain Research. 1975 Nov;98(3):417–40.
27. Lowet E, Kondabolu K, Zhou S, Mount RA, Wang Y, Ravasio CR, et al. Deep brain stimulation creates informational lesion through membrane depolarization in mouse hippocampus. Nat Commun. 2022 Dec 13;13(1):7709.
28. Liu DF, Chen YC, Zhu GY, Wang X, Jiang Y, Liu HG, et al. Effects of anterior thalamic nuclei stimulation on gene expression in a rat model of temporal lobe epilepsy. Acta Neurol Belg. 2020 Dec;120(6):1361–70.
29. Song S, Song S, Cao C, Lin X, Li K, Sava V, et al. Hippocampal Neurogenesis and the Brain Repair Response to Brief Stereotaxic Insertion of a Microneedle. Stem Cells International. 2013;2013:1–14.
30. Vedam-Mai V, Van Battum EY, Kamphuis W, Feenstra MGP, Denys D, Reynolds BA, et al. Deep brain stimulation and the role of astrocytes. Mol Psychiatry. 2012 Feb;17(2):124–31.
31. McIntyre CC, Grill WM, Sherman DL, Thakor NV. Cellular Effects of Deep Brain Stimulation: Model-Based Analysis of Activation and Inhibition. Journal of Neurophysiology. 2004 Apr;91(4):1457–69.
32. McIntyre CC, Savasta M, Kerkerian-Le Goff L, Vitek JL. Uncovering the mechanism(s) of action of deep brain stimulation: activation, inhibition, or both. Clinical Neurophysiology. 2004 Jun;115(6):1239–48.
33. Perea G, Navarrete M, Araque A. Tripartite synapses: astrocytes process and control synaptic information. Trends in Neurosciences. 2009 Aug;32(8):421–31.
34. Halassa MM, Haydon PG. Integrated Brain Circuits: Astrocytic Networks Modulate Neuronal Activity and Behavior. Annu Rev Physiol. 2010 Mar 17;72(1):335–55.
35. Giaume C, Koulakoff A, Roux L, Holcman D, Rouach N. Astroglial networks: a step further in neuroglial and gliovascular interactions. Nat Rev Neurosci. 2010 Feb;11(2):87–99.
36. Zhang Y, Barres BA. Astrocyte heterogeneity: an underappreciated topic in neurobiology. Current Opinion in Neurobiology. 2010 Oct;20(5):588–94.
37. Bekar L, Libionka W, Tian GF, Xu Q, Torres A, Wang X, et al. Adenosine is crucial for deep brain stimulation–mediated attenuation of tremor. Nat Med. 2008 Jan;14(1):75–80.
38. Tawfik VL, Chang SY, Hitti FL, Roberts DW, Leiter JC, Jovanovic S, et al. Deep Brain Stimulation Results in Local Glutamate and Adenosine Release: Investigation Into the Role of Astrocytes. Neurosurgery. 2010 Aug;67(2):367–75.
39. Hamilton NB, Attwell D. Do astrocytes really exocytose neurotransmitters? Nat Rev Neurosci. 2010 Apr;11(4):227–38.
40. Florence G, Sameshima K, Fonoff ET, Hamani C. Deep Brain Stimulation: More Complex than the Inhibition of Cells and Excitation of Fibers. Neuroscientist. 2016 Aug;22(4):332–45.
41. Sajib SZK, Lee MB, Kim HJ, Woo EJ, Kwon OI. Extracellular Total Electrolyte Concentration Imaging for Electrical Brain Stimulation (EBS). Sci Rep. 2018 Jan 10;8(1):290.
42. Reddy GD, Lozano AM. Postmortem studies of deep brain stimulation for Parkinson’s disease: a systematic review of the literature. Cell Tissue Res. 2018 Jul;373(1):287–95.