Advances in neuromodulation for drug-resistant epilepsy:transitioning from open-loop stimulation to closed-loop stimulation
PING An
ZHU Jun-ming
Abstract：Over the recent years,electrical stimulation therapy has rapidly evolved as a commonly used neuromodulation therapy for epilepsy.Although open-loop stimulation[such as vagus nerve stimulation(VNS)and anterior nucleus of the thalamus deep brain stimulation(ANT-DBS)]has achieved certain success in treating drug-resistant epilepsy,its fixed-parameters,continuous stimulation paradigm suffers from limitations such as a mismatch between timing and dosage,poor individual adaptability,and more.In contrast,closed-loop stimulation[exemplified by responsive neurostimulator system(RNS)]significantly enhances treatment precision and energy efficiency by monitoring brain activity in real time and delivering responsive stimulation before or during seizures.It also leverages long-term data to optimize stimulation parameters and promote brain network remodeling.This review outlines the development,mechanisms,and recent advances in drug-resistant epilepsy neuromodulation from open-loop stimulation to closed-loop stimulation,and discusses future prospects for more predictive,adaptive,and network-oriented approaches,providing a theoretical foundation for personalized and precise epilepsy treatment.
Keywords：Drug resistant epilepsyElectric stimulation therapyIntralaminar thalamic nucleiAnterior thalamic nucleiPulvinarReview
Publication Date：2026-01-25
Online Publishing Date：2026-04-07(First online date of this platform, not the publication date of the document)
Pages：7( 50-56 )