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Lookup NU author(s): Professor Andrew Trevelyan, Dr Rob Graham, Professor Andrew Jackson
© The Author(s) 2025. Published by Oxford University Press on behalf of the Guarantors of Brain. Brain stimulation has, for many decades, been considered as a potential solution for the unmet needs of the many people living with drug-resistant epilepsy. Clinically, there are several different approaches in use, including vagus nerve stimulation, deep brain stimulation of the thalamus, and responsive neurostimulation. Across populations of patients, all deliver reductions in seizure load and sudden unexpected death in epilepsy risk, yet do so variably, and the improvements seem incremental rather than transformative. In contrast, within the field of experimental neuroscience, the transformational impact of optogenetic stimulation is evident; by providing a means to control subsets of neurons in isolation, it has revolutionized our ability to dissect out the functional relations within neuronal microcircuits. It is worth asking, therefore, how preclinical optogenetics research could advance clinical practice in epilepsy? Here, we review the state of the clinical field, and the recent progress in preclinical animal research. We report various breakthrough results, including the development of new models of seizure initiation, its use for seizure prediction, and for fast, closed-loop control of pathological brain rhythms, and what these experiments tell us about epileptic pathophysiology. Finally, we consider how these preclinical research advances may be translated into clinical practice.
Author(s): Trevelyan AJ, Marks VS, Graham RT, Denison T, Jackson A, Smith EH
Publication type: Review
Publication status: Published
Journal: Brain
Year: 2025
Volume: 148
Issue: 3
Pages: 746-752
Print publication date: 01/03/2025
Online publication date: 02/01/2025
Acceptance date: 11/11/2024
ISSN (print): 0006-8950
ISSN (electronic): 1460-2156
Publisher: Oxford University Press
URL: https://doi.org/10.1093/brain/awae385
DOI: 10.1093/brain/awae385
PubMed id: 39745924
