Advancing Epilepsy Treatment and Brain Research Through SEEG: Alexander C. Whiting, MD

WATCH TIME: 7 minutes

"With SEEG, we’re not just locating the ‘needle in the haystack’ for epilepsy, but we’re also unlocking a deeper understanding of the brain’s complex networks and decision-making processes."

Drug-resistant epilepsy (DRE) poses a significant clinical challenge, as patients often continue to experience seizures despite the use of antiepileptic drugs. Untreated refractory epilepsy is frequently associated with progressive cognitive decline, further impacting quality of life. Responsive neurostimulation (RNS) has emerged as a neuromodulatory option for patients unsuitable for resection or ablation, with growing evidence supporting its efficacy in seizure reduction. However, questions remain about its impact on neuropsychiatric outcomes and its potential to mitigate the cognitive effects of refractory epilepsy.

In a new retrospective study, researchers analyzed pre- and post-operative neuropsychiatric evaluations of 11 patients with DRE who underwent RNS implantation following standard diagnostic workup, including stereoelectroencephalography (SEEG) to identify the seizure onset zone. Results showed no statistically significant changes in most domains, including memory, attention, and executive function. However, a subtle but statistically significant decrease in Verbal Comprehension Index was noted (P = .028). These findings suggest that RNS implantation stabilizes key neuropsychiatric functions in patients with DRE, although larger studies may be needed to further explore its long-term cognitive effects.

These findings were presented at the 2024 American Epilepsy Society Annual Meeting, held December 6-10, in Los Angeles, by senior author Alexander C. Whiting, MD, the director of epilepsy surgery at Allegheny Health Network, and colleagues. Recently, Whiting sat down in an interview with NeurologyLive^® to further discuss how the SEEG procedure compares with traditional methods of epilepsy surgery in terms of patient outcomes and recovery. He also talked about the potential applications that might arise from analyzing brain data during everyday activities in patients with epilepsy. Moreover, Whiting spoke about how understanding the brain’s risk-reward circuitry impact treatments for disorders like obsessive-compulsive disorder and depression.

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REFERENCES
1. Nashman Z, Yadlapalli V, Kite T, et al. Responsive Neurostimulation for Epileptic Seizures Does Not Lead to Reduction in Neuropsychiatric Outcomes in Patients. Presented at: AES 2024; December 6-10; Los Angeles, CA.