Mayo Clinic develops personalized brain stimulation method that could transform epilepsy treatment

UAE—Researchers at Mayo Clinic have taken a significant step forward in treating drug-resistant epilepsy by developing a personalized approach to deep brain stimulation.

Rather than applying the same treatment blueprint to every patient, the team now maps each patient’s unique brainwave patterns before deciding where to place electrodes and how to deliver electrical pulses.

The method represents a notable departure from the standard practice in the field, where physicians typically target the same brain region across all patients regardless of how their seizures manifest.

Deep brain stimulation, commonly referred to as DBS, works by delivering carefully calibrated electrical pulses through electrodes implanted deep within the brain.

These pulses help disrupt abnormal brain activity that triggers seizures, offering patients who have not responded well to medication a meaningful alternative.

However, the traditional approach has long relied on a standardized placement strategy—one that does not account for the fact that each patient’s seizure network operates differently.

Brain mapping prior to treatment

Mayo Clinic physician-scientists now take a different route. Before any electrode reaches the operating room, clinicians study the patient’s brain wave activity to identify the specific region driving their seizures.

This preparatory step allows the medical team to tailor both the location and the settings of the stimulation to the individual patient, rather than defaulting to a general approach.

Nick Gregg, M.D., a Mayo Clinic neurologist and the lead author of a study published in the Annals of Neurology, explained the reasoning behind this shift.

The team’s approach centers on maximizing what they call “seizure network engagement,” which means targeting the precise point where stimulation will have the greatest impact on abnormal brain activity.

Because seizures can occur infrequently, clinicians do not wait for one to happen.

Instead, they analyze the erratic brain wave patterns that signal the presence of abnormal activity, even between seizure episodes, to build a detailed picture of each patient’s neural landscape.

Thalamus function

A key structure in this process is the thalamus, a small relay hub situated deep within the brain.

The thalamus connects different brain regions and plays a critical role in how electrical signals travel across the brain.

Once the research team identifies the specific part of the thalamus that connects to a patient’s seizure network, they can adjust the stimulation settings accordingly.

This precision allows clinicians to disrupt what Dr. Gregg describes as pathological hypersynchrony—essentially, a state in which brain cells fire together in an abnormal, overstimulated pattern—and reduce the overall excitability of the network to lower seizure risk.

Early results and next steps

The team initially applied this personalized method to ten patients who were already undergoing evaluation for epilepsy surgery.

Those patients served as the foundation for the approach, and several of them have since received permanent DBS implants guided by the same individualized mapping process.

The next phase of the research will follow these patients over time to track long-term treatment outcomes and gather data on its effectiveness.

Dr. Gregg expressed optimism about where this line of research could ultimately lead. The long-term vision extends beyond simply controlling seizures.

By repeatedly and precisely targeting the seizure network, the researchers believe they may be able to reorganize the underlying neural pathways—effectively quieting the network until the brain no longer produces seizures on its own.

If that goal proves achievable, the implications would shift the conversation in epilepsy care from management to cure.

Part of a larger innovation initiative

This research is part of a broader Mayo Clinic initiative, Bioelectronic Neuromodulation Innovation to Cure (BIONIC).

The program combines clinical expertise with advanced engineering to develop new diagnostics and therapies for complex neurological conditions.

Through the development of intellectual property, strategic partnerships, and carefully designed patient-centered trials, BIONIC works to move promising innovations out of the laboratory and into the hands of patients who need them most.