Epilepsy brain implant does not transform patients' sense of self or personality but offers them new insights into illness, study shows

Date:
September 3, 2021
Source:
Taylor & Francis Group
Summary:
A next-generation brain implant currently in clinical use for
treating refractory epilepsy -- to help prevent symptoms including
seizures - - does not induce changes to patients' personalities
or self-perceptions, a new study of patient experiences shows.



FULL STORY ==========================================================================
A next-generation brain implant currently in clinical use for treating refractory epilepsy -- to help prevent symptoms including seizures --
does not induce changes to patients' personalities or self-perceptions,
a new study of patient experiences shows.


==========================================================================
The findings, published in the peer-reviewed journal AJOB
Neuroscience,will help alleviate some ethical concerns that have been
raised around closed-loop brain stimulation devices which could,
in theory, have unintended effects on a person's sense of self or
personality.

"Next-generation brain stimulation devices can modulate brain activity
without human intervention, which raises new ethical and policy
questions. But while there is a great deal of speculation about the
potential consequences of these innovative treatments, very little is
currently known about patients' experiences of any device approved for
clinical use," said lead author Tobias Haeusermann of the University
of California.

"This issue is becoming even more pressing, as several similar treatments
are currently under development for several common neurological and
psychiatric conditions, including depression, anxiety chronic pain,
Alzheimer's disease and ischemic stroke -- offering the promise of
effective new treatments for these debilitating illnesses." Closed-loop
brain stimulation systems can monitor and decode brain activity and automatically adjust treatment -- delivered through electrical pulses
-- based on internal software algorithms. These implantable devices
may 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 pre-programmed stimulation
to targeted brain areas.

Epilepsy is a brain disorder that causes seizures and affects around
three million US adults. Around one-third of people with the condition
will eventually develop refractory epilepsy -- which means that
current medications don't work well, or at all, at controlling their
seizures. While brain surgery can be helpful, it isn't suitable for
all patients.

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

"We found that the 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, led to changes in their self-perceptions
-- 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 the many others who may consider this treatment as a way to
prevent their seizures in the future." The results also highlighted the importance of evaluating the potential effects of brain stimulation in
relation to patients' previous neurological conditions and medications,
which were recognized by both patients and family members as having a
profound impact on their 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 of understanding and making sense of their illness. But the results of the
study also indicated that if a patient's experiences are not corroborated
by the technology, they and others around them can begin to question
their understanding of their illness.

"While patients generally valued the opportunity to view
data collected by these devices, the process could also create
uncertainties. Generating what appeared to be objective records of their illness might be interpreted as discrediting a patient's own reports,"
said Haeusermann. "Researchers may need to more carefully consider how
patients will make meaning from data that are collected, stored and
interpreted by these devices. Design choices such as user interface,
options for data use and portability, and the degree of anticipated
interaction with clinicians, may have unintended effects on how patients understand their brains and brain conditions." However, the authors
noted that the brain implant used for these epilepsy patients does not
have many of the more advanced functions that are envisioned for future devices. For example, these systems might be designed to exert effects specifically through programmed alterations to patients' personalities
and behaviors for treating psychiatric disorders.

========================================================================== Story Source: Materials provided by Taylor_&_Francis_Group. Note:
Content may be edited for style and length.


========================================================================== Journal Reference:
1. Tobias Haeusermann, Cailin R. Lechner, Kristina Celeste Fong, Alissa
Bernstein Sideman, Agnieszka Jaworska, Winston Chiong, Daniel Dohan.

Closed-Loop Neuromodulation and Self-Perception in Clinical
Treatment of Refractory Epilepsy. AJOB Neuroscience, Sept. 2,
2021; DOI: 10.1080/ 21507740.2021.1958100 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2021/09/210902191613.htm

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