Cooling of the epileptic focus suppresses seizures with minimal influence on neurologic functions

Masami Fujii, Takao Inoue, Sadahiro Nomura, Yuichi Maruta, Yeting He, Hiroyasu Koizumi, Satoshi Shirao, Yuji Owada, Ichiro Kunitsugu, Toshitaka Yamakawa, Tatsuji Tokiwa, Satoshi Ishizuka, Takeshi Yamakawa, Michiyasu Suzuki

Research output: Contribution to journalArticlepeer-review

38 Citations (Scopus)

Abstract

Purpose: Focal brain cooling is effective for suppression of epileptic seizures, but it is unclear if seizures can be suppressed without a substantial influence on normal neurologic function. To address the issue, a thermoelectrically driven cooling system was developed and applied in free-moving rat models of focal seizure and epilepsy. Methods: Focal seizures limited to the unilateral forelimb were induced by local application of a penicillin G solution or cobalt powder to the unilateral sensorimotor cortex. A proportional integration and differentiation (PID)-controlled, thermoelectrically driven cooling device (weight of 11 g) and bipolar electrodes were chronically implanted on the eloquent area (on the epileptic focus) and the effects of cooling (20, 15, and 10°C) on electrocorticography, seizure frequency, and neurologic changes were investigated. Key Findings: Cooling was associated with a distinct reduction of the epileptic discharges. In both models, cooling of epileptic foci significantly improved both seizure frequency and neurologic functions from 20°C down to 15°C. Cooling to 10°C also suppressed seizures, but with no further improvement in neurologic function. Subsequent investigation of sensorimotor function revealed significant deterioration in foot-fault tests and the receptive field size at 15°C. Significance: Despite the beneficial effects in ictal rats, sensorimotor functions deteriorated at 15°C, thereby suggesting a lower limit for the therapeutic temperature. These results provide important evidence of a therapeutic effect of temperatures from 20 to 15°C using an implantable, hypothermal device for focal epilepsy.

Original languageEnglish
Pages (from-to)485-493
Number of pages9
JournalEpilepsia
Volume53
Issue number3
DOIs
Publication statusPublished - 2012 Mar
Externally publishedYes

Keywords

  • Epilepsy
  • Focal brain cooling
  • Implantable device
  • Therapeutic temperatures

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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