Deep Brain Stimulation of the Pulvinar for the Treatment of Posterior Quadrant Epilepsy

Researchers at Pitt are exploring neuromodulation through deep brain stimulation of the pulvinar as an alternative treatment approach for posterior quadrant epilepsy (PCE). The rationale is based on growing evidence of the involvement of subcortical structures, particularly the thalamus, in the organization of epileptiform activity.

Description

This is a novel system and method to treat intractable seizures affecting the posterior quadrant of the brain through electrical stimulation of the pulvinar, a region of the thalamus. Epilepsy is a prevalent neurological disorder, affecting approximately 50 million people worldwide. Over 30% of individuals with epilepsy suffer from medically refractory epilepsy, where seizures cannot be fully controlled by medication. For patients with epilepsy localized to eloquent cortical areas like the posterior quadrant, the risks of surgical resection can be prohibitive, as it may lead to debilitating neurological deficits like vision loss.

Applications

• Epilepsy
• Intractable seizures treatment
• Refractory posterior quadrant epilepsy

Advantages

Compared to the current standard of care for medically refractory PCE, which relies on high-risk cortical resection, the neuromodulation approach offers several potential advantages. By targeting a subcortical structure like the pulvinar, it may avoid the neurological deficits associated with directly disrupting eloquent cortical areas. Additionally, the ability to titrate stimulation parameters and apply closed-loop, responsive stimulation could improve the efficacy and tolerability of the intervention.

Invention Readiness

This technology is at the level of in vivo data. In the proposed system, a deep brain electrode would be surgically implanted in the pulvinar to deliver electrical stimulation. Various stimulation parameters are described, including charge-balanced pulses with widths between 100 us and 2 ms, frequencies between 100-1000 Hz, and amplitudes up to 10mA. Stimulation could be applied continuously or in a phasic manner, adjusting over the course of a seizure. Other neuromodulation approaches, such as optical stimulation via implanted optical fibers, are also mentioned as potential alternatives.

IP Status

https://patents.google.com/patent/WO2025235968A1