Next-generation brain sensing, stimulation, and adaptive control devices for epilepsy

Electrical sensing and stimulation devices have significantly improved the quality of life for people with epilepsy. Neurotechnology has rapidly advanced and is poised to have a further impact for people with epilepsy. In some sense, epilepsy may be considered a “privileged” disease since robust electrophysiological biomarkers of the disease, ictal and interictal epileptiform activity, are well established signatures of abnormal brain excitability and provide targets for tracking and treating disease. Electrical brain stimulation for focal epilepsy is supported by class-I evidence and is FDA approved. But progress is slowed by the inability of current devices to effectively quantify, track, and treat the known biomarkers. In the future, therapy optimization for seizures and common epilepsy comorbidities will benefit from next-generation systems designed to integrate implantable brain devices with wearable sensors and off-the-body computing resources (smartphones and cloud resources) and enable adaptive stimulation therapy.