Abstract

The pathogenesis and management of intractable epilepsy (IE) remain challenging to neuroscientists even today. Electrical stimulation therapies like vagal nerve and deep brain stimulation (DBS) are gaining popularity as effective adjunctive treatments with a continued search for newer DBS targets. The strong antiepileptic influence of rapid eye movement sleep (REMS) controlled by acetylcholine neurons (AChN) in the pedunculpontine nucleus (PPN) in humans is well documented, the stimulation of which has been found to induce and enhance REMS. Furthermore, a specific reduction of AChN in the PPN has been observed in autopsy examination of patients with West syndrome (a severe form of epilepsy). Therefore, in view of the strong antiepileptic influence of REMS and its control by AChN in PPN, it is postulated that the PPN may be electrically stimulated as per pre-configurable programming and requirement for enhancing the genesis of REMS during the night sleep time to provide protection against epileptogenesis and seizureoccurrence. The PPN is also responsible for initiation of locomotion and control of gait based on which patents on PPN stimulation in movement disorders like Parkinson’s disease and as therapy for sleep disorders are already available. This brief article presents a recent patent on PPN stimulation in IE.

Keywords: Acetylcholine neurons, biomarker of intractability, deep brain stimulation, EEG-desynchronization, EEGsynchronization, electrical stimulation therapy, pedunculopontine nucleus, polysomnography, REM sleep.