ABSTRACT
A focal brain cooling system for treatment of refractory epilepsy that is implantable and wearable may permit patients with this condition to lead normal daily lives. We have developed such a system for cooling of the epileptic focus by delivery of cold saline to a cooling device that is implanted cranially. The outflow is pumped for circulation and cooled by a Peltier device. Here, we describe the design of the system and evaluate its feasibility by simulation. Mathematical models were constructed based on equations of fluid dynamics and data from a cat model. Computational fluid dynamics simulations gave the following results: 1) a cooling device with a complex channel structure gives a more uniform temperature in the brain; 2) a cooling period of <10 min is required to reach an average temperature of 25.0°Cat 2 mm below the brain surface, which is the target temperature for seizure suppression. This time is short enough for cooling of the brain before seizure onset after seizure prediction by an intracranial electroencephalogram-based algorithm; and 3) battery charging would be required once every several days for most patients. These results suggest that the focal brain cooling system may be clinically applicable.
Subject(s)
Brain , Cold Temperature , Seizures/prevention & control , Algorithms , Animals , Brain/physiopathology , Cats , Computer Simulation , Electric Power Supplies , Electrocorticography , Equipment Design , Humans , Models, Theoretical , Seizures/physiopathology , Titanium , Wearable Electronic DevicesABSTRACT
Epilepsy is a group of diseases caused by excessive neuronal activities, and one-quarter of the patients do not become seizure-free by the existing treatments. The potential treatments include focal brain cooling, which aims to cool the region where the excessive neuronal activities begin. We are developing a focal brain cooling system. The system delivers cold saline to a cranially implanted cooling device. The outflow is cooled by a Peltier device and pumped for circulation. The Peltier device and the pump are activated only when a seizure is predicted. In this research, the length of time for cooling the brain was calculated with a computational fluid dynamics (CFD)-based model of the focal brain cooling system. As a result, it takes less than 10 minutes for the average temperature 2 mm below the cooling device to reach 25.0 °C. It is much shorter than the time from seizure prediction to seizure onset when an existing algorithm for prediction is used.
