Seizure and psychosocial outcomes in patients with DBS for intractable epilepsy.

Abstract

Objectives: This study evaluates seizure outcomes in patients with intractable epilepsy treated with Deep Brain Stimulation (DBS) and explores correlations with demographic and psychosocial factors.

Methods: We analyzed data from patients who underwent Medtronic-DBS implantation between 2018 and 2023 at our institution. Collected variables included sex, age, epilepsy type, prior epilepsy surgeries, age at diagnosis and DBS implantation, DBS lead location, seizure outcomes, anti-seizure medication (ASM) use, employment, Patient Reported Outcomes Measurement Information System (PROMIS) Depression T-scores pre- and post-DBS, antidepressant use, and driving status. Patients were classified as Total Responders (TR) if they achieved ≥ 50 % seizure reduction. Associations between responder status and assessed factors were analyzed using chi-square and Mann-Whitney U tests.

Results: Seventeen patients (five males, twelve females; mean age 37.1 years, SD=10.7) were included, with an average epilepsy duration of 24.3 years (SD=13.1) before DBS. Leads were placed in the anterior thalamus (88 %) and centro-median nuclei (12 %). Fourteen patients (82 %) had multifocal epilepsy, while three (18 %) had symptomatic generalized epilepsy. TR status was achieved in 59 % of patients at a mean follow up of 32 months. Responder status correlated with higher ASM burden but not with other psychosocial factors.

Conclusion: DBS therapy resulted in > 50 % seizure reduction in 59 % of patients with intractable epilepsy, with responders exhibiting a higher median ASM burden. While psychosocial factors were not significantly linked to seizure outcomes, TR patients demonstrated a relative worsening of Depression T-scores compared to non-responders, warranting further investigation.