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Review
. 2022 Jun 16:9:889561.
doi: 10.3389/fvets.2022.889561. eCollection 2022.

Neurostimulation as a Method of Treatment and a Preventive Measure in Canine Drug-Resistant Epilepsy: Current State and Future Prospects

Marta Nowakowska  1 , Muammer Üçal  1 , Marios Charalambous  2 , Sofie F M Bhatti  3 , Timothy Denison  4 , Sebastian Meller  2 , Gregory A Worrell  5 , Heidrun Potschka  6 , Holger A Volk  2
Affiliations
Review

Neurostimulation as a Method of Treatment and a Preventive Measure in Canine Drug-Resistant Epilepsy: Current State and Future Prospects

Marta Nowakowska et al. Front Vet Sci. .

Abstract

Modulation of neuronal activity for seizure control using various methods of neurostimulation is a rapidly developing field in epileptology, especially in treatment of refractory epilepsy. Promising results in human clinical practice, such as diminished seizure burden, reduced incidence of sudden unexplained death in epilepsy, and improved quality of life has brought neurostimulation into the focus of veterinary medicine as a therapeutic option. This article provides a comprehensive review of available neurostimulation methods for seizure management in drug-resistant epilepsy in canine patients. Recent progress in non-invasive modalities, such as repetitive transcranial magnetic stimulation and transcutaneous vagus nerve stimulation is highlighted. We further discuss potential future advances and their plausible application as means for preventing epileptogenesis in dogs.

Keywords: deep brain stimulation; dogs; drug-resistant epilepsy; epileptogenesis; seizure; transcranial magnetic stimulation; vagus nerve stimulation.

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Conflict of interest statement

GW has rights to receive future royalties from the licensing of technology to Cadence Neuroscience Inc, and has received research support from Medtronic, LivaNova, and was previously on the scientific advisory board of NeuroPace Inc. HV served as paid consultant in the field of epilepsy for Boehringer Ingelheim, CEVA animal health, Nestle Purina and served as contract researcher for: Nestle Purina, Desitin Pharma and Boehringer Ingelheim. HP received funding for consulting, talks and research collaborations from Eisai, Zogenix, Elanco, Roche, Exeed Epidarex, Arvelle and MSD. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
A demonstrative illustration of assembly of invasive VNS (A) and DBS (B) in a dog. VNS electrodes are mostly wrapped around the cervical portion of left vagus nerve, whereas DBS electrodes are usually placed in thalamic nuclei. Wires and a controlling device are usually located in a dorsal cervical region. Created with BioRender.com.
Figure 2
Figure 2
Advantages and challenges related to each of the neurostimulation methods used in veterinary medicine to treat drug-resistant epilepsy in dogs. VNS, vagus nerve stimulation; DBS, deep brain stimulation; TMS, transcranial magnetic stimulation.
Figure 3
Figure 3
Future perspectives for neurostimulation in drug-resistant epilepsy in dogs. Long-term stimulation might lead to disease modifying effects through alterations in neuronal networks (upper part) or anti-inflammatory effects (middle part), which might be utilized to curb epileptogenic processes. Use of repetitive transcranial magnetic stimulation (rTMS) or transcranial direct current stimulation (tDCS) might both be considered non-invasive strategies for long-term stimulation in patients not eligible for surgery.
See this image and copyright information in PMC

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