The implant effect after intracranial electrode placement: is transient clinical improvement explained by post-implantation electrophysiological changes?

It has been repeatedly observed that implanting electrodes in the brain or on the brain is occasionally associated with a transient improvement in seizure control. This improvement was observed with responsive neurostimulation (Morrell et al., 2011), deep brain stimulation (Velasco et al., 2006; Fisher et al., 2010; Valentin et al., 2013), and even diagnostic intracranial electrode implantation (Schulze-Bonhage et al., 2010; Roth et al., 2012; Kovac et al., 2014). In the pivotal trial of anterior thalamic stimulation, there was a 21-22% median seizure frequency reduction in the first month after implantation, prior to randomization (Fisher et al., 2010).

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