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Review
. 2022 Sep 1;79(9):937-944.
doi: 10.1001/jamaneurol.2022.1936.

Focal Cooling for Drug-Resistant Epilepsy: A Review

Itamar Niesvizky-Kogan  1   2 , Michelle Bass  1 , Shira R Goldenholz  2 , Daniel M Goldenholz  1   2
Affiliations
Review

Focal Cooling for Drug-Resistant Epilepsy: A Review

Itamar Niesvizky-Kogan et al. JAMA Neurol. .

Abstract

Importance: Epilepsy affects at least 1.2% of the population, with one-third of cases considered to be drug-resistant epilepsy (DRE). For these cases, focal cooling therapy may be a potential avenue for treatment, offering hope to people with DRE for freedom from seizure. The therapy leverages neuroscience and engineering principles to deliver a reversible treatment unhindered by pharmacology.

Observations: Analogous to (but safer than) the use of global cooling in postcardiac arrest and neonatal ischemic injury, extensive research supports the premise that focal cooling as a long-term treatment for epilepsy could be effective. The potential advantages of focal cooling are trifold: stopping epileptiform discharges, seizures, and status epilepticus safely across species (including humans).

Conclusions and relevance: This Review presents the most current evidence supporting focal cooling in epilepsy. Cooling has been demonstrated as a potentially safe and effective treatment modality for DRE, although it is not yet ready for use in humans outside of randomized clinical trials. The Review will also offer a brief overview of the technical challenges related to focal cooling in humans, including the optimal device design and cooling parameters.

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Figures

Figure 1:
Figure 1:
Focal cooling safety, effectiveness, and availability of closed loop system in various species
Figure 2:
Figure 2:
Closed-Loop Focal Cooling for Epilepsy
See this image and copyright information in PMC

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