Long-term efficacy and safety of thalamic stimulation for drug-resistant partial epilepsy
Vicenta Salanova,Thomas C. Witt,Robert M. Worth,Thomas R. Henry,Robert E. Gross,Jules M. Nazzaro,Douglas Labar,Michael R. Sperling,Ashwini Sharan,Evan Sandok,Adrian Handforth,John M. Stern,Steve Chung,Jaimie M. Henderson,Jacqueline A. French,Gordon H. Baltuch,William E. Rosenfeld,Paul A. Garcia,Nicholas M. Barbaro,Nathan B. Fountain,W. Jeffrey Elias,Robert R. Goodman,John R. Pollard,Alexander I. Tröster,Christopher P. Irwin,Kristin Lambrecht,Nina M. Graves,Robert S. Fisher +27 more
TLDR
This long-term follow-up provides Class IV evidence that for patients with drug-resistant partial epilepsy, anterior thalamic stimulation is associated with a 69% reduction in seizure frequency and a 34% serious device-related adverse event rate at 5 years.Abstract:
Objective: To report long-term efficacy and safety results of the SANTE trial investigating deep brain stimulation of the anterior nucleus of the thalamus (ANT) for treatment of localization-related epilepsy. Methods: This long-term follow-up is a continuation of a previously reported trial of 5- vs 0-V ANT stimulation. Long-term follow-up began 13 months after device implantation with stimulation parameters adjusted at the investigators9 discretion. Seizure frequency was determined using daily seizure diaries. Results: The median percent seizure reduction from baseline at 1 year was 41%, and 69% at 5 years. The responder rate (≥50% reduction in seizure frequency) at 1 year was 43%, and 68% at 5 years. In the 5 years of follow-up, 16% of subjects were seizure-free for at least 6 months. There were no reported unanticipated adverse device effects or symptomatic intracranial hemorrhages. The Liverpool Seizure Severity Scale and 31-item Quality of Life in Epilepsy measure showed statistically significant improvement over baseline by 1 year and at 5 years ( p Conclusion: Long-term follow-up of ANT deep brain stimulation showed sustained efficacy and safety in a treatment-resistant population. Classification of evidence: This long-term follow-up provides Class IV evidence that for patients with drug-resistant partial epilepsy, anterior thalamic stimulation is associated with a 69% reduction in seizure frequency and a 34% serious device-related adverse event rate at 5 years.read more
Citations
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Epilepsy in adults
TL;DR: Improved understanding of the gradual development of epilepsy, epigenetic determinants, and pharmacogenomics comes the hope for better, disease-modifying, or even curative, pharmacological and non-pharmacological treatment strategies.
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Andres M. Lozano,Nir Lipsman,Hagai Bergman,Peter Brown,Stephan Chabardes,Jin Woo Chang,Keith Matthews,Cameron C. McIntyre,Thomas E. Schlaepfer,Michael Schulder,Yasin Temel,Jens Volkmann,Joachim K. Krauss +12 more
TL;DR: How DBS has facilitated advances in the authors' understanding of how circuit malfunction can lead to brain disorders is considered and the key unmet challenges and future directions in the DBS field are outlined.
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Nine-year prospective efficacy and safety of brain-responsive neurostimulation for focal epilepsy
TL;DR: This study provides Class IV evidence that brain-responsive neurostimulation significantly reduces focal seizures with acceptable safety over 9 years and provides significant and sustained reductions in the frequency of FOS with improved QOL.
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An improved neuroanatomical model of the default-mode network reconciles previous neuroimaging and neuropathological findings.
Pedro Nascimento Alves,Chris Foulon,Chris Foulon,Chris Foulon,Vyacheslav Karolis,Vyacheslav Karolis,Vyacheslav Karolis,Danilo Bzdok,Daniel S. Margulies,Daniel S. Margulies,Emmanuelle Volle,Emmanuelle Volle,Michel Thiebaut de Schotten +12 more
TL;DR: A more comprehensive neuroanatomical model of the default-mode network (DMN) including subcortical structures such as the basal forebrain, cholinergic nuclei, anterior and mediodorsal thalamic nuclei is proposed and found that thalamus and basal fore brain are central to the DMN.
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Brain-responsive neurostimulation in patients with medically intractable mesial temporal lobe epilepsy
Eric B. Geller,Tara L. Skarpaas,Robert E. Gross,Robert R. Goodman,Gregory L. Barkley,Carl W. Bazil,Michael J. Berg,Gregory K. Bergey,Sydney S. Cash,Andrew J. Cole,Robert B. Duckrow,Jonathan C. Edwards,Stephan Eisenschenk,James Fessler,Nathan B. Fountain,Alicia M. Goldman,Ryder P. Gwinn,Christianne N. Heck,Aamar Herekar,Lawrence J. Hirsch,Barbara C. Jobst,David King-Stephens,Douglas Labar,James W. Leiphart,W. Richard Marsh,Kimford J. Meador,Eli M. Mizrahi,Anthony M. Murro,Dileep Nair,Katherine H. Noe,Yong D. Park,Paul Rutecki,Vicenta Salanova,Raj D. Sheth,Donald C. Shields,Christopher Skidmore,Michael C. Smith,David C. Spencer,Shraddha Srinivasan,William O. Tatum,Paul C. Van Ness,David G. Vossler,Robert E. Wharen,Gregory A. Worrell,Daniel Yoshor,Richard S. Zimmerman,Kathy Cicora,Felice T. Sun,Martha J. Morrell +48 more
TL;DR: In this paper, the authors evaluated the seizure-reduction response and safety of brain-responsive stimulation in adults with medically intractable partial-onset seizures of mesial temporal lobe origin.
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TL;DR: A multicenter, double‐blind, randomized trial of bilateral stimulation of the anterior nuclei of the thalamus for localization‐related epilepsy is reported.
Journal ArticleDOI
Responsive cortical stimulation for the treatment of medically intractable partial epilepsy
TL;DR: This study provides Class I evidence that responsive cortical stimulation is effective in significantly reducing seizure frequency for 12 weeks in adults who have failed 2 or more antiepileptic medication trials, 3 or more seizures per month, and 1 or 2 seizure foci.
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Early Surgical Therapy for Drug-Resistant Temporal Lobe Epilepsy: A Randomized Trial
Jerome Engel,Michael P. McDermott,Samuel Wiebe,John T. Langfitt,John M. Stern,Sandra Dewar,Michael R. Sperling,Irenita Gardiner,Giuseppe Erba,Itzhak Fried,Margaret Jacobs,Harry V. Vinters,Scott Mintzer,Karl Kieburtz +13 more
TL;DR: Whether surgery soon after failure of 2 antiepileptic drug (AED) trials is superior to continued medical management in controlling seizures and improving quality of life (QOL) is sought and among patients with newly intractable disabling MTLE, resective surgery plus AED treatment resulted in a lower probability of seizures during year 2 of follow-up than continued AEDtreatment alone.
Journal ArticleDOI
Chronic anterior thalamus stimulation for intractable epilepsy.
TL;DR: A significant number of patients with epilepsy remain poorly controlled despite antiepileptic medication (AED) treatment and are not eligible for resective surgery, so novel therapeutic methods are required to decrease seizure burden in this population.
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