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Abstract
<p class="first" id="d2584207e69">Introduction: Epilepsy affects more than 1% of the
US population, and over 30% of
adults with epilepsy do not respond to antiseizure medications without life-impacting
medication-related side effects. Resection of the seizure focus is not an option for
many patients because it would cause unacceptable neurological or cognitive harm.
For these patients, neuromodulation has emerged as a nondestructive, effective, and
safe alternative. The NeuroPace® RNS® System, the only brain-responsive neurostimulation
device, records neural activity from leads placed at one or two seizure foci. When
the neurostimulator detects epileptiform activity, as defined for each patient by
his or her physician, brief pulses of electrical stimulation are delivered to normalize
the activity.Areas covered: This review describes the RNS System, the results of multi-year
clinical trials, and the research discoveries enabled by the chronic ambulatory brain
data collected by the RNS System.Expert commentary: Brain-responsive neurostimulation
could potentially be used to treat any episodic neurological disorder that's accompanied
by a neurophysiological biomarker of severity. Combining advanced machine learning
approaches with the chronic ambulatory brain data collected by the RNS System could
eventually enable automatic fine-tuning of detection and stimulation for each patient,
creating a general-purpose neurotechnological platform for precision medicine.
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