This will be a prospective, pilot, open-label, two-arm, parallel-group, randomized study to evaluate the efficacy and safety of low-intensity focused ultrasound (LIFU) neuromodulation using NaviFUS System in patients with drug-resistant epilepsy (DRE).
The study aims to demonstrate the efficacy and safety of LIFU neuromodulation in DRE patients, showing its ability to decrease targeted neuronal activity and alleviate epileptic seizures. Drug-resistant epilepsy (at least 3 anti-seizure medication failed) patients whose epileptogenic foci have been determined by comprehensive presurgical evaluation and meet all eligibility criteria may participate in this study by providing informed consent. Eligible patients will undergo a 8-week baseline observation screening period and will be asked to keep a 8-week seizure diary. This diary will serve as a baseline prior to treatment and will continue to be recorded throughout the treatment and follow-up period. This study will enroll a maximum of 16 eligible patients. Eligible patients will be randomized into two groups to receive three-consecutive 5-minute twice (low dose group) or three-consecutive 10-minute FUS treatment twice (high dose group) in a week using assigned ultrasound exposure doses generated by the NaviFUS System. Following treatment, there will be a 24-week follow-up period. Patients will be allowed concomitant use of anti-seizure medications (ASMs) throughout the whole study period.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
16
The mechanism of action of FUS neuromodulation involves the activation of voltage-gated ion channels to induce temporary neuromodulation.
Taipei Veterans General Hospital
Taipei, Taiwan
RECRUITINGChanges of seizure frequency after treatment compared to baseline
The changes in patient's seizure frequency from baseline through the study completion will be assessed based on the seizure diaries.
Time frame: up to 33 weeks
Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability]
The incidence and severity of AEs associated with LIFU neuromodulation in patients with DRE.
Time frame: up to 33 weeks
Responder rate (≧50% seizure reduction)
The changes in responder rate (≧50% seizure reduction) from baseline through the study completion will be assessed based on the seizure diaries.
Time frame: up to 33 weeks
Change from baseline in number of seizure-free days
The changes in number of seizure-free days from baseline through the study completion will be assessed based on the seizure diaries.
Time frame: up to 33 weeks
Change from baseline in subjective seizure strength
The changes in subjective seizure strength from baseline through the study completion will be assessed based on the seizure diaries.
Time frame: up to 33 weeks
Quality of Life in Epilepsy (QOLIE-31)
The QOLIE-31 is a survey of health-related quality of life for adults with epilepsy. There are 31 questions about patient's health and daily activities. The total score is calculated as a weighted mean of the sub-scale scores and the scoring of the QOLIE-31 requires the conversion of raw data to a scale of 0 to 100 for each sub-scale, with higher scores reflecting higher quality of life.
Time frame: up to 33 weeks
Changes of Beck Anxiety Inventory (BAI) after treatment compared to baseline
BAI is a 21-question multiple-choice self-report inventory that is used to measure the severity of anxiety. Each answer is scored on a scale value of 0 (not at all) to 3 (severely). Higher total scores indicate more severe anxiety symptoms.
Time frame: up to 33 weeks
Changes of Beck Depression Inventory (BDI) after treatment compared to baseline
BDI-II, a 21-question multiple-choice self-report inventory, is a psychological test used to measure the severity of depression. Each answer is rated on a scale of 0 (none at all) to 3 (severe). Higher total scores indicate more severe depressive symptoms.
Time frame: up to 33 weeks
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