Clinical trials of surgical neuromodulation therapies for epilepsy: Past, present & future

Neuromodulation is expanding as an avenue of therapy for patients with either focal- or generalized-onset epilepsy. Current implantable surgical options include deep brain stimulation (DBS), responsive neurostimulation (RNS®; NeuroPace), vagus nerve stimulation (VNS) and, more recently, subscalp, transcranial stimulation (EASEE®). This review of the literature discusses the milestone clinical trials that have shaped our practice of surgical neuromodulation for epilepsy, summarizes ongoing clinical trials, and speculates on the future of clinical trials in this field.