Epilepsy brain implant does not transform patients’ self-esteem or personality, but gives them new insights into the disease, study finds – ScienceDaily

The results, published in the peer-reviewed journal AJOB Neurosciences,will help alleviate some of the ethical concerns that have been raised about closed-loop brain stimulation devices that could, in theory, have unintended effects on a person’s self-esteem or personality.

“Next-generation brain stimulation devices can modulate brain activity without human intervention, raising new ethical and political questions. any device approved for clinical use, ”said lead author Tobias Haeusermann of the University of California.

“This problem is becoming even more urgent, as several similar treatments are currently in development for several common neurological and psychiatric disorders, including depression, anxiety, chronic pain, Alzheimer’s disease and ischemic stroke. , offering the promise of new effective treatments for these debilitating diseases. “

Closed-loop brain stimulation systems can monitor and decode brain activity and automatically adjust therapy – delivered by electrical impulses – based on internal software algorithms. These implantable devices can provide more precise and personalized treatment than “open loop” systems, which have been used for decades to treat Parkinson’s disease and other conditions by applying consistent, preprogrammed stimulation to targeted areas of the brain.

Epilepsy is a brain disorder that causes seizures and affects approximately three million American adults. About a third of people with this condition will eventually develop refractory epilepsy, which means that current medications don’t work well, if at all, to control their seizures. While brain surgery can be helpful, it is not for all patients.

In 2013, the United States Food and Drug Administration (FDA) approved a closed-loop brain stimulation system for the treatment of refractory epilepsy. This study followed 12 patients and their family caregivers for two years to learn about their experiences with this implant, which is the first clinically approved and commercially available closed-loop brain stimulation device.

“We found that brain implants did not transform patients’ sense of self or personality. Neither the long-term implantation of the electronic device in their brain, nor the electrical stimulation to modulate their brain function, did not. have led to changes in their self-perception – or the perceptions of the patient by family members and others around them, “said Haeusermann.” This is reassuring news for more than 3,000 patients with refractory epilepsy implanted with this device to date – as well as for the many others who may view this treatment as a way to prevent their seizures in the future. “

The findings also underscored the importance of weighing the potential effects of brain stimulation against neurological disorders and patients’ prior medications, which were recognized by patients and their families as having a profound impact on their health. personality and self-perception.

The ability of next-generation brain stimulation devices to record, store and display brain data could also offer patients new ways to understand and make sense of their disease. But the results of the study also indicated that if a patient’s experiences are not corroborated by technology, he and others around them may begin to question their understanding of their disease.

“While patients generally appreciate the ability to view the data collected by these devices, the process could also create uncertainty. Generating what appeared to be objective records of their disease could be interpreted as discrediting a patient’s own reports.” , said Haeusermann. “Researchers may need to take a closer look at how patients make sense of the data collected, stored and interpreted by these devices. Design choices such as user interface, options for use and portability of data, and the degree of anticipated interaction with clinicians have unintended effects on how patients understand their brains and brain disorders. “

However, the authors noted that the brain implant used for these epilepsy patients does not have many of the more advanced features envisioned for future devices. For example, these systems could be designed to exert effects specifically through programmed alterations in the personality and behavior of patients for the treatment of psychiatric disorders.