Scholars@Duke
Shruti Agashe

Shruti Agashe

Assistant Professor of Neurology
Neurology, Epilepsy and Sleep
shruti.agashe@duke.edu
Box 90361, Durham, NC 27708-0361
Law School Library, Durham, NC 27708

Selected Publications

Responsive neurostimulation detections: "Recognizing the unseen".

Journal Article Epileptic Disord · October 2025 BACKGROUND: Closed-loop responsive neurostimulation (RNS) is an established non-resective neuromodulatory therapy for individuals with drug-resistant epilepsy (DRE). RNS systems are typically programmed to detect and respond to predefined seizure onset pat ... Full text Open Access Link to item Cite

Leveraging Functional and Structural Connectomics to Guide Neuromodulation in Epilepsy.

Journal Article J Clin Neurophysiol · July 25, 2025 Epilepsy is not solely a disorder of abnormal brain structure; it is fundamentally a disorder of disrupted brain networks and impaired communication across brain regions. Thalamic neuromodulation, once conceptualized as a fixed, anatomically guided interve ... Full text Link to item Cite

Individualizing Programming of Responsive Neurostimulation and Deep Brain Stimulation Therapies in Epilepsy.

Journal Article J Clin Neurophysiol · July 25, 2025 Responsive neurostimulation and deep brain stimulation have emerged as effective intracranial neuromodulation therapies for drug-resistant epilepsy when surgical resection is not an option. However, programming these devices presents unique challenges in e ... Full text Link to item Cite

A Scoping Review of Responsive Neurostimulation in Focal Cortical Dysplasia-Related Epilepsy.

Journal Article Epilepsy Behav · May 2025 OBJECTIVE: Responsive Neurostimulation (RNS) is a closed-loop neuromodulation therapy approved for treating drug resistant epilepsy (DRE) with 1 or 2 seizure foci, but its potential utility for treating complex seizure networks, such as in focal cortical d ... Full text Link to item Cite

Focal to bilateral tonic-clonic seizures in newly diagnosed focal epilepsy.

Journal Article Epilepsia · April 2025 Presence of focal to bilateral tonic-clonic seizures (FBTCS) in focal epilepsy is associated with increased morbidity and mortality. Risk factors for FBTCS are poorly understood, and little is known regarding FBTCS recurrence after treatment initiation. Th ... Full text Link to item Cite

Focused Ultrasound in the Treatment of Epilepsy: Current Applications and Future Directions.

Journal Article Stereotact Funct Neurosurg · 2025 INTRODUCTION: Epilepsy is the fourth most common neurological disorder, affecting nearly 1% of the global population. Despite recent advancements in medical therapies, approximately one-third of patients remain refractory to treatment, necessitating consid ... Full text Link to item Cite

Thalamocortical network neuromodulation for epilepsy.

Journal Article Brain Commun · 2025 Despite the growing interest in network-guided neuromodulation for epilepsy, uncertainty about the safety and long-term efficacy of thalamocortical stimulation persists. Our evaluation focused on the use of a four-lead open-loop implantable pulse generator ... Full text Link to item Cite

Sleep-related hypermotor seizures originating from the occipital lobe.

Journal Article Epileptic Disord · December 2024 We present two unique cases of sleep-related hypermotor epilepsy (SHE) originating from the occipital lobe. Patients with sleep-related seizures and drug-resistant occipital lobe epilepsy were identified from the ANPHY lab stereo-electroencephalography (SE ... Full text Link to item Cite

Centromedian thalamic deep brain stimulation for idiopathic generalized epilepsy: Connectivity and target optimization.

Journal Article Epilepsia · November 2024 There are limited treatment options for individuals with drug-resistant idiopathic generalized epilepsy (IGE). Small, limited case series suggest that centromedian thalamus deep brain stimulation (CM-DBS) may be an effective treatment option. The optimal C ... Full text Link to item Cite

EEG Source Localization in Temporal Encephaloceles: Concordance With Surgical Resection and Clinical Outcomes.

Journal Article J Clin Neurophysiol · September 1, 2024 PURPOSE: Temporal encephaloceles are a cause of drug-resistant temporal lobe epilepsy; however, their relationship with epileptogenesis is unclear, and optimal surgical resection is uncertain. EEG source localization (ESL) may guide surgical decision-makin ... Full text Link to item Cite

Stereoelectroencephalography of the Deep Brain: Basal Ganglia and Thalami.

Journal Article J Clin Neurophysiol · July 1, 2024 Stereoelectroencephalography (SEEG) has emerged as a transformative tool in epilepsy surgery, shedding light on the complex network dynamics involved in focal epilepsy. This review explores the role of SEEG in elucidating the role of deep brain structures, ... Full text Link to item Cite

Patterns of antiseizure medication utilization in the Human Epilepsy Project.

Journal Article Epilepsia · December 2023 OBJECTIVE: This study was undertaken to ascertain the natural history and patterns of antiseizure medication (ASM) use in newly diagnosed focal epilepsy patients who were initially started on monotherapy. METHODS: The data were derived from the Human Epile ... Full text Link to item Cite

Implications of intracranial hemorrhage associated with stereo-EEG.

Journal Article Clin Neurophysiol · November 2023 OBJECTIVE: Intracranial hemorrhage (ICH) is a known complication during stereo-electroencephalography (sEEG) however true rates remain unknown. We provide a comprehensive review of ICH during sEEG regardless of clinical symptoms. Secondly, we analyzed sEEG ... Full text Link to item Cite

Cenobamate in Generalized Epilepsy and Combined Generalized and Focal Epilepsy.

Journal Article Neurol Clin Pract · April 2023 BACKGROUND AND OBJECTIVES: Cenobamate (CNB) is a United States Food and Drug Administration-approved antiseizure medication (ASM) for focal-onset seizures; however, its potential clinical effectiveness as a broad-spectrum ASM is not established. CNB has a ... Full text Link to item Cite

Temporal encephalocele: An epileptogenic focus confirmed by direct intracranial electroencephalography.

Journal Article Epilepsy Behav Rep · 2023 Several studies have suggested the epileptogenic potential of temporal encephaloceles. However, there is limited literature describing the results of intracranial EEG monitoring for patients with temporal encephaloceles. We describe a 19 year-old right-han ... Full text Link to item Cite

Centromedian Nucleus of the Thalamus Deep Brain Stimulation for Genetic Generalized Epilepsy: A Case Report and Review of Literature.

Journal Article Front Hum Neurosci · 2022 There is a paucity of treatment options for cognitively normal individuals with drug resistant genetic generalized epilepsy (GGE). Centromedian nucleus of the thalamus (CM) deep brain stimulation (DBS) may be a viable treatment for GGE. Here, we present th ... Full text Link to item Cite

Incidence, predictors, and outcomes of post-thrombectomy seizures in the extended time window.

Journal Article Epilepsy Behav Rep · 2021 Mechanical thrombectomy 6-24 h after the last time where a patient was known to be without signs or symptoms of a stroke is the standard of care for patients with a stroke due to large vessel occlusion. This is referred to as thrombectomy within an extende ... Full text Link to item Cite

Cardiac Autonomic Neuropathy in Diabetes Mellitus.

Journal Article Methodist Debakey Cardiovasc J · 2018 Cardiovascular autonomic neuropathy (CAN) is a severely debilitating yet underdiagnosed condition in patients with diabetes. The prevalence can range from 2.5% (based on the primary prevention cohort in the Diabetes Control and Complications Trial) to as h ... Full text Link to item Cite

Effects of Electrical Stimulation in the Inferior Colliculus on Frequency Discrimination by Rhesus Monkeys and Implications for the Auditory Midbrain Implant.

Journal Article J Neurosci · May 4, 2016 UNLABELLED: Understanding the relationship between the auditory selectivity of neurons and their contribution to perception is critical to the design of effective auditory brain prosthetics. These prosthetics seek to mimic natural activity patterns to achi ... Full text Open Access Link to item Cite

An in vitro assessment of acoustic radiation force impulse imaging for visualizing cardiac radiofrequency ablation lesions.

Journal Article J Cardiovasc Electrophysiol · May 2010 INTRODUCTION: Lesion placement and transmurality are critical factors in the success of cardiac transcatheter radiofrequency ablation (RFA) treatments for supraventricular arrhythmias. This study investigated the capabilities of catheter transducer based a ... Full text Link to item Cite