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Allen L. Ho, Anne-Mary N. Salib, Arjun V. Pendharkar, Eric S. Sussman, William J. Giardino, and Casey H. Halpern

responsive neurostimulation systems in the treatment of epilepsy has demonstrated the effectiveness of “closed-loop” recording and intermittent stimulation systems for the treatment of episodic electrical pathology within the brain. 45 Consumption-driven disorders of impulsivity may be ideal for this type of closed-loop treatment if stimulation could be delivered during brief windows of anticipation, or so-called moments of weakness prior to the initiation of a binge. 8 , 60 Wu et al. recently published a translational study validating this technique. They were able to

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Allen L. Ho, Yagmur Muftuoglu, Arjun V. Pendharkar, Eric S. Sussman, Brenda E. Porter, Casey H. Halpern, and Gerald A. Grant

obtained. Fourteen patients underwent or were offered a resective surgery, 2 patients underwent responsive neurostimulation (RNS), 2 patients have been offered RNS, and 1 patient had laser interstitial thermal therapy (LITT). There was an average postoperative follow-up of 7.92 months. In patients who underwent definitive epilepsy surgery with at least 3 months of follow-up (n = 12), 50% achieved an Engel class I result (seizure freedom), 25% had Engel class III (some seizure reduction), and 25% had Engel class IV (no improvement in seizures) ( Table 3 ). TABLE 3