Thomas Foutz, MD, PhD
Assistant Professor, WashU Neurology
- Phone: 314-454-6120
- Email: tfoutz@nospam.wustl.edu
Treatment of refractory epilepsies using neurostimulation methods, including deep brain and responsive neural stimulation devices
Our research goal is to advance the treatment of refractory epilepsy through innovative neurostimulation therapies. With over 3.4 million people affected by epilepsy in the United States and approximately 30% suffering from drug-resistant epilepsy (DRE), the pursuit of more effective treatments is greatly needed. My lab aims to understand the mechanisms by which neural stimulation alters brain activity to suppress seizures (Figure 1) and influence disease progression. Our ultimate goal is to significantly improve neurostimulation technology and, thereby, the quality of life for those with epilepsy.
Our multimodal approach involves preclinical, computational, and clinical studies. By integrating these perspectives, we aim to refine neurostimulation therapies to make treatment plans more precise and personalized. We are investigating the role of electrical neurostimulation in addressing drug-resistant epilepsy, exploring improvements in FDA-approved therapies such as Vagus Nerve Stimulation (VNS), Deep Brain Stimulation (DBS), and Responsive Neural Stimulation (RNS). Our research seeks to shed light on the neurophysiologic processes underpinning these treatments, which are yet to be fully understood.
Our research has led to the hypothesis that manipulating spatial and temporal parameters can enhance the therapeutic effect of neurostimulation. Spatially, we are examining the influence of where stimulation occurs across multiple brain regions (Figure 2). Temporally, we are reviewing the impact of stimulation parameters, such as frequency, since high frequencies can inhibit neuronal activity, whereas low frequencies can enhance GABA-mediated inhibition. This work aims to determine how clinical adjustments in spatial and temporal factors modify the outcomes of seizures and disease progression.
To advance our understanding of epileptogenesis and seizure-induced brain injury, we have developed high-throughput acute seizure models to optimize the spatiotemporal parameters of neurostimulation. We use preclinical models of Tuberous Sclerosis and chemogenic-induced temporal lobe epilepsy to probe the acute seizure-suppressing effects of neurostimulation and its potential to modify the disease course of epilepsy. Moreover, our studies extend to understanding the interplay between epilepsy and sleep, investigating how neurostimulation may affect sleep architecture and quality. Recognizing the intricate link between epilepsy, sleep disturbances, and overall neurological health, this aspect of our research is vital for developing holistic treatment strategies.
In summary, we are investigating the relationship between neurostimulation and the therapeutic effect on epilepsy. Through rigorous experimentation and a commitment to translational research, we aspire to find novel therapeutic targets and strategies to transform epilepsy care.