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Epilepsy Behav. 2018 Sep 27;88:152-161. doi: 10.1016/j.yebeh.2018.09.004. [Epub ahead of print]

Electrical stimulation of the piriform cortex for the treatment of epilepsy: A review of the supporting evidence.

Author information

1
The Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre, 245 Burgundy Street, Heidelberg, Victoria 3084, Australia; Florey Department of Neuroscience and Mental Health, The University of Melbourne, Melbourne, 30 Royal Parade, Parkville, Victoria 3052, Australia. Electronic address: james.young@unimelb.edu.au.
2
The Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre, 245 Burgundy Street, Heidelberg, Victoria 3084, Australia; Florey Department of Neuroscience and Mental Health, The University of Melbourne, Melbourne, 30 Royal Parade, Parkville, Victoria 3052, Australia; Department of Neurology, Austin Health, Melbourne, 145 Studley Road, Heidelberg, Victoria 3084, Australia.
3
The Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre, 245 Burgundy Street, Heidelberg, Victoria 3084, Australia; ISN Psychology - Institute for Social Neuroscience, Melbourne, Level 6/10 Martin Street, Heidelberg, Victoria 3084, Australia; School of Psychology and Public Health, La Trobe University, Melbourne, Plenty Road and Kingsbury Drive, Bundoora, VIC 3068, Australia.

Abstract

In this review, we consider how the piriform cortex is engaged in both focal and generalized epilepsy networks and postulate the various neural pathways that can be effectively neuromodulated by stimulation at this site. This highlights the common involvement of the piriform cortex in epilepsy. We address both current and future preclinical studies of deep brain stimulation (DBS) of the piriform cortex, with attention to the critical features of these trials that will enable them to be of greatest utility in informing clinical translation. Although recent DBS trials have utilized thalamic targets, electrical stimulation of the piriform cortex may also be a useful intervention for people with epilepsy. However, more work is required to develop a solid foundation for this approach before considering human trials.

KEYWORDS:

Deep brain stimulation; Epilepsy; Piriform cortex

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