Biomarker Targeted Stimulation for Epileptiform Events

NCT06424977 | Not Yet Recruiting DMC FDA Device

• 1 other identifier: CAD2004
• Study Type: interventional
• Target: 40
• Locations: 0 countries
• Sites: N/A

Brief Summary

This is a multicenter, prospective, controlled study designed to evaluate treatment with the BTS System.

Conditions

Epilepsy

Outcome Measures

Primary Outcomes (1)

• Adverse event rate

  Determine adverse event rate, including adverse device effects and serious adverse events

  Intervals through 7, 12, and 24 months post-implant

Secondary Outcomes (8)

• Seizure frequency

  Intervals calculated at 4 to 7 months and through 12 and 24 months post-implant.

• Neurocognitive testing

  Evaluated at 7 months, 12 months, and 24 months post-implant.

• Depression testing

  Evaluated at 7 months, 12 months, and 24 months post-implant.

• Anxiety testing

  Evaluated at 7 months, 12 months, and 24 months post-implant.

• Quality of life testing

  Evaluated at 7 months, 12 months, and 24 months post-implant.

Study Arms (1)

Treatment

EXPERIMENTAL

Device: Biomarker Targeted Stimulation (BTS)

Interventions

Biomarker Targeted Stimulation (BTS) DEVICE

Using continuous stimulation to target multiple network nodes, Biomarker Targeted Stimulation (BTS) is intended to suppress abnormal interictal activity, as determined by biomarkers including interictal epileptiform discharges (IED) and high frequency oscillations (HFO), with the intention to reduce brain hyperexcitability, thereby limiting seizure occurrence.

Treatment

Eligibility Criteria

• Age: 7 Years+
• Sex: male
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Subject is greater than or equal to 7 years of age.
• Subject has focal onset seizures.
• Subject has failed treatment with a minimum of two AED's used in typical therapeutic dosages.
• Subject has seizures that are distinct, stereotypical events that can be reliably counted by the patient or caregiver.
• Subject can reasonably be expected to maintain a seizure diary and the BTS System alone, or with the assistance of a competent individual.
• For one month prior to enrollment, subject's anti-epileptic medication dosages and ketogenic diet (as applicable) have been stable (other than acute, intermittent use of benzodiazepines) and subject has had at least three primary, disabling seizures per month, on average. Seizures must be separated by a minimum of eight hours not to be considered part of a cluster. A cluster, for the purpose of this criterion, shall be considered a single seizure.
• Subject is able to complete regular office visits and telephone appointments in accordance with the study protocol requirements.
• A female subject of childbearing age must have a negative serum pregnancy test within two weeks prior to implant of the INSR, and, if sexually active, must be using a reliable form of birth control, be surgically sterile, or be at least two years post-menopausal.
• Subject has been informed of their eligibility for resective surgery as a potential alternative to the study, if such surgery is a reasonable option.
• Subject has had a brain MRI epilepsy evaluation within the past two years.
• Subject's anatomy will permit implantation of the INSR within 20 mm of the skin surface.

You may not qualify if:

• Subject has a history of substance abuse within the preceding two years.
• Subject participated in another drug or device trial that may confound study results within the preceding 30 days.
• Subject is implanted with pacemaker, implantable cardiac defibrillator, cardiac management product, or a medical device that interferes with the BTS System or with which the BTS System interferes. Patients with a vagus nerve stimulator (VNS) implanted may be enrolled, provided their clinical status has been stable for at least one month prior to enrollment at their current stimulation parameter settings.
• Subject has anatomy that may interfere with electrode placement.
• Subject is on anticoagulants and is unable to discontinue them perisurgically, as required by the neurosurgeon or Investigator.
• Subject has significant platelet dysfunction from medical conditions or medications (including, particularly, aspirin or sodium valproate). If platelet dysfunction is suspected, subject can be enrolled only if a hematologist, the Investigator, and the neurosurgeon judge it to be advisable.
• Subject has been diagnosed with psychogenic or non-epileptic seizures that cannot be distinguished from their epileptogenic events.
• Subject is ineligible for cranial surgery.

Sponsors & Collaborators

• Cadence Neuroscience: lead

Related Publications (5)

• Lundstrom BN, Worrell GA, Stead M, Van Gompel JJ. Chronic subthreshold cortical stimulation: a therapeutic and potentially restorative therapy for focal epilepsy. Expert Rev Neurother. 2017 Jul;17(7):661-666. doi: 10.1080/14737175.2017.1331129. Epub 2017 May 25.

  PMID: 28532252 BACKGROUND

• Kerezoudis P, Grewal SS, Stead M, Lundstrom BN, Britton JW, Shin C, Cascino GD, Brinkmann BH, Worrell GA, Van Gompel JJ. Chronic subthreshold cortical stimulation for adult drug-resistant focal epilepsy: safety, feasibility, and technique. J Neurosurg. 2018 Aug;129(2):533-543. doi: 10.3171/2017.5.JNS163134. Epub 2017 Oct 20.

  PMID: 29053073 BACKGROUND

• Lundstrom BN, Gompel JV, Khadjevand F, Worrell G, Stead M. Chronic subthreshold cortical stimulation and stimulation-related EEG biomarkers for focal epilepsy. Brain Commun. 2019;1(1):fcz010. doi: 10.1093/braincomms/fcz010. Epub 2019 Sep 6.

  PMID: 31667473 BACKGROUND

• Starnes K, Miller K, Wong-Kisiel L, Lundstrom BN. A Review of Neurostimulation for Epilepsy in Pediatrics. Brain Sci. 2019 Oct 18;9(10):283. doi: 10.3390/brainsci9100283.

  PMID: 31635298 BACKGROUND

• Alcala-Zermeno JL, Gregg NM, Van Gompel JJ, Stead M, Worrell GA, Lundstrom BN. Cortical and thalamic electrode implant followed by temporary continuous subthreshold stimulation yields long-term seizure freedom: A case report. Epilepsy Behav Rep. 2020 Sep 2;14:100390. doi: 10.1016/j.ebr.2020.100390. eCollection 2020.

  PMID: 32995742 BACKGROUND

MeSH Terms

Conditions

Epilepsy

Condition Hierarchy (Ancestors)

Brain Diseases; Central Nervous System Diseases; Nervous System Diseases

Central Study Contacts

David Himes, BSEE

CONTACT

425-679-9505; dhimes@cadenceneuro.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: INDUSTRY
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: May 9, 2024
• First Posted: May 22, 2024
• Study Start (Estimated): September 1, 2026
• Primary Completion (Estimated): September 1, 2028
• Study Completion (Estimated): February 14, 2030
• Last Updated: May 18, 2026

Record last verified: 2026-05