Development of a focal cerebral cooling system for the treatment of intractable epilepsy: An experimental study in cats and non-human primates

Focal brain cooling is under investigation in clinical trials of drug resistant epilepsy. This method has been studied intensively in rodents, but more evidence from large animal studies is required. To provide evidence that focal brain cooling is a safe and effective therapeutic intervention for intractable focal epilepsy, we investigated the placement of a newly-developed cooling device over the motor cortex of animals and investigated whether focal brain cooling can prevent and/or terminate focal neocortical seizures without having a significant impact on behavior. Two cats (n = 2) and a macaque monkey (n = 1) were chronically implanted with an epidural focal brain cooling device over the somatosensory and motor cortex, with adjacent EEG electrodes and a micro-injection tube. Penicillin G (PG) was delivered via the tube for induction of local seizures. Recordings were performed under awake but weakly restrained conditions. The cats and monkey exhibited spontaneous seizures with repetitive epileptiform discharges after administration of PG, and these discharges decreased at 15°C cooling. The results of this study suggest that epidural focal brain cooling is a safe and effective potential treatment modality for intractable focal epilepsy.