Epilepsy Research最新文献

{"title":"Reaffirming construct validity: A response to methodological concerns","authors":"Elif Sarac , Esra Yildiz","doi":"10.1016/j.eplepsyres.2025.107619","DOIUrl":"10.1016/j.eplepsyres.2025.107619","url":null,"abstract":"","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"217 ","pages":"Article 107619"},"PeriodicalIF":2.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A closer look at construct validity: Methodological pitfalls in the Turkish adaptation of the perceived disability scale","authors":"Prateek Kumar Panda, Indar Kumar Sharawat","doi":"10.1016/j.eplepsyres.2025.107618","DOIUrl":"10.1016/j.eplepsyres.2025.107618","url":null,"abstract":"","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"217 ","pages":"Article 107618"},"PeriodicalIF":2.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood-brain barrier impairment as an early marker of neurodegeneration in late-onset epilepsy of unknown origin","authors":"Silvia Maio ,&nbsp;Mariana Fernandes ,&nbsp;Fabio Placidi ,&nbsp;Francesca Izzi ,&nbsp;Alessandro Castelli ,&nbsp;Andrea Pagano ,&nbsp;Nicola Biagio Mercuri ,&nbsp;Claudio Liguori","doi":"10.1016/j.eplepsyres.2025.107614","DOIUrl":"10.1016/j.eplepsyres.2025.107614","url":null,"abstract":"<div><h3>Purpose</h3><div>Blood-brain barrier (BBB) plays a crucial role in maintaining brain health, and its dysfunction during the early stages of neurodegeneration may contribute to neuropathological processes. Patients with late-onset epilepsy with unknown etiology (LOEU) can present early signs of neurodegeneration and convert to an overt neurodegenerative disease longitudinally. This study analyzed cerebrospinal-fluid (CSF)/serum albumin ratio (Qalb), as a marker of BBB integrity, and assessed biomarkers of neurodegeneration in patients with LOEU compared to age- and sex-matched controls.</div></div><div><h3>Methods</h3><div>Patients diagnosed with LOEU were compared to a sex- and age-matched control group. All participants underwent a neurological visit, cognitive evaluation to exclude cognitive impairment, and a lumbar puncture for CSF biomarker analysis [β-Amyloid₄₂ (Aβ₄₂); total-Tau (t-Tau); phosphorylated-Tau at threonine 181 (p-Tau181); Qalb]. Lumbar puncture was performed within 2 months after epilepsy diagnosis, and at least 3 weeks after the last seizure.</div></div><div><h3>Results</h3><div>Twenty-eight LOEU patients (53.6 % female, mean age 68.79 ± 7.83 y) and twenty-five controls (52.0 % female, mean age 65.64 ± 8.10 y) were included. LOEU patients showed significantly higher Qalb values (<em>p</em> = 0.003), lower Aβ₄₂ CSF levels (<em>p</em> = 0.030), and higher t-Tau/Aβ₄₂ (<em>p</em> = 0.030) and p-Tau181/Aβ₄₂ ratios (<em>p</em> = 0.030) than controls. Qalb values did not significantly differ between patients with and without pathological AD biomarker profile.</div></div><div><h3>Conclusions</h3><div>LOEU patients show BBB dysfunction and early changes in CSF biomarker ratios pointing to AD pathology. Qalb increase seems to be unrelated to the pathological changes in CSF AD biomarkers. Future studies should be performed to better understand the neuropathological basis of LOEU and the risk for patients to develop a neurodegenerative disorder.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"217 ","pages":"Article 107614"},"PeriodicalIF":2.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144489930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Turning data analytics into an organisational asset: A landscape population analysis of 5720 people with epilepsy attending outpatient care in Ireland","authors":"Derek Corrigan ,&nbsp;Colin P. Doherty ,&nbsp;Tim Jacquemard ,&nbsp;Norman Delanty ,&nbsp;Máire White ,&nbsp;Mary Fitzsimons","doi":"10.1016/j.eplepsyres.2025.107613","DOIUrl":"10.1016/j.eplepsyres.2025.107613","url":null,"abstract":"<div><h3>Introduction</h3><div>The National Clinical Programme for Epilepsy (NCPE) in Ireland identified analytics applied to Electronic Patient Record (EPR) data as an organisational asset for driving continuous service improvement. This study describes the diagnostic, therapeutic and prognostic characteristics of a population of people with epilepsy (PwE) currently taking anti-epileptic drugs. This is an epidemiological question of interest to clinicians, PwE and their families, along with those involved in heath policy, and health service planning, implementation, monitoring and evaluation.</div></div><div><h3>Material and methods</h3><div>A de-identified data extract of 5720 PwE was taken from the Irish epilepsy EPR. Phenotypical characteristics were aggregated and visualised using data analytics. A set of landscape analyses fully describe this subpopulation in terms of epilepsy types, seizure types, seizure frequencies, aetiologies, comorbidities and numbers of anti-epileptic-drugs taken.</div></div><div><h3>Results</h3><div>A multi-disciplinary team of epilepsy healthcare providers and stakeholders reviewed the analytics results from which they identified a number of policy issues that required improvement relating to current epilepsy service delivery including:<ul><li><span>•</span><span><div>Equity of care relating to less refractory and older people with epilepsy.</div></span></li></ul></div><div><ul><li><span>•</span><span><div>Further review of patient cohorts taking greater than 4 AEDs with a view to describing underlying aetiologies of patients with complex epilepsy that may be poorly controlled.</div></span></li></ul><ul><li><span>•</span><span><div>Closer integration of other clinical disciplines that reflects diverse needs of PwE e.g. mental health and geriatric services.</div></span></li></ul></div><div><ul><li><span>•</span><span><div>Development of national capacity for genetic testing and preventative strategies for epilepsy.</div></span></li></ul></div></div><div><h3>Significance</h3><div>This study demonstrates how interrogation and analysis of large volumes of patient data can be applied to a real-world epilepsy EPR that is used in frontline epilepsy clinical care. This analytics approach was supported by a multi-disciplinary review of outputs to support a data-driven approach that interprets analytics with a view to improving actual clinical care.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"217 ","pages":"Article 107613"},"PeriodicalIF":2.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144489919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between statin use and post-ischemic stroke epilepsy among older adults: A nested case-control study","authors":"R. Grace Couper ,&nbsp;Tresah C. Antaya ,&nbsp;Brooke Carter ,&nbsp;Salimah Z. Shariff ,&nbsp;Luciano A. Sposato ,&nbsp;Flory T. Muanda ,&nbsp;Jorge G. Burneo","doi":"10.1016/j.eplepsyres.2025.107617","DOIUrl":"10.1016/j.eplepsyres.2025.107617","url":null,"abstract":"<div><div>Our primary objective was to estimate the association between post-stroke statin use and post-stroke epilepsy (PSE) and assess whether sex modifies this association. Our second objective was to assess whether statin characteristics and other risk factors affect the risk of PSE overall and within groups defined by sex. We conducted a population-based nested case-control study, using linked health administrative data and including residents older than 65 of Ontario, Canada treated for an ischemic stroke between April 1, 2007, and March 31, 2017. Patients who developed epilepsy were matched with up to 10 controls on age, sex, and month. Multivariable conditional logistic regression models were used to estimate the adjusted odds ratios for PSE associated with post-stroke statin use and potential risk factors. We included 1009 patients with epilepsy and 6522 matched controls. Statin use was not associated with the risk of epilepsy in the entire cohort or in the sex-stratified analysis (IRR = 1.17; 95 % CI 0.95–1.43), and sex did not significantly modify the association (p-value=0.08). Statin characteristics did not affect the risk of epilepsy in the entire cohort; however, we observed an increased risk of PSE associated with the use of atorvastatin among females in the sex-stratified analyses (IRR = 1.26; 95 % CI 1.02–1.56). Although the risk of epilepsy did not significantly differ between statin users and non-users in the entire cohort or within groups defined by sex, atorvastatin was associated with an increased risk of PSE compared to statin non-users among women and should be further explored.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"217 ","pages":"Article 107617"},"PeriodicalIF":2.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144365091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seizure outcome and anti-seizure medication use in post-stroke epilepsy: A retrospective cohort study","authors":"Ahmed Khadija ,&nbsp;Jacques Theitler ,&nbsp;Revital Gandelman-Marton","doi":"10.1016/j.eplepsyres.2025.107616","DOIUrl":"10.1016/j.eplepsyres.2025.107616","url":null,"abstract":"<div><h3>Background</h3><div>Most patients with post-stroke epilepsy (PSE) are considered to be well controlled with anti-seizure medications (ASMs). First-generation ASMs with potent enzyme-inducing properties can reduce the efficacy of concomitant medications and were related to increased mortality in PSE.</div></div><div><h3>Objective</h3><div>To evaluate seizure outcome and patterns of ASM use in patients with PSE.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed the computerized database and the medical records of all the patients who had their first visit in our adult outpatient epilepsy clinic during a 10-year period (2012–2021), and identified 39 patients with PSE and 382 patients with focal epilepsy without a previous stroke (FEWS).</div></div><div><h3>Results</h3><div>The study group included 421 patients aged 18–90 years, 220 (52.3 %) men, follow-up duration 3.1 ± 2.9 years. At first observation, patients with PSE had lower rates of daily to monthly seizures (p = 0.023) and higher rates of a single seizure (p = 0.023) compared to patients with FEWS, and 66 % were treated with first-generation ASMs. At last observation, seizure frequency improved in fewer patients with PSE compared to FEWS (p = 0.042), with significant decrease in the rate of daily to monthly seizures in patients with FEWS (p = 0.0001).</div></div><div><h3>Conclusions</h3><div>Seizure outcome in patients with PSE may be less favorable than previously reported, and many were still treated with ASMs that can adversely affect vascular risk. Further studies are needed to evaluate therapeutic strategies that can improve seizure control and achieve higher rates of seizure freedom in patients with PSE.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"217 ","pages":"Article 107616"},"PeriodicalIF":2.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144322937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antiseizure medication discontinuation: A mixed-methods exploration of factors considered by patients when approaching decision-making","authors":"Samuel W. Terman ,&nbsp;Jordan M. Silva ,&nbsp;Max Kuster ,&nbsp;Jasper Lee ,&nbsp;Amanda Brand ,&nbsp;Kara Manuel ,&nbsp;Navya Kalia ,&nbsp;Micaela Dugan ,&nbsp;Marla Reid ,&nbsp;Katherine Mortati ,&nbsp;Alexandra Tolmasov ,&nbsp;Palak S. Patel ,&nbsp;James F. Burke ,&nbsp;Arthur C. Grant ,&nbsp;Susanna S. O’Kula ,&nbsp;Chloe E. Hill","doi":"10.1016/j.eplepsyres.2025.107615","DOIUrl":"10.1016/j.eplepsyres.2025.107615","url":null,"abstract":"<div><h3>Objectives</h3><div>Antiseizure medications (ASMs) represent standard treatment for epilepsy. Yet, ASMs have adverse effects, and seizure risk decreases with longer seizure freedom. Guidelines consider ASM withdrawal after a period of seizure freedom. However, work exploring how patients approach this decision is scarce. We inquired what decision-making factors patients feel are relevant to ASM discontinuation.</div></div><div><h3>Methods</h3><div>We conducted a mixed-methods study of adults seen for epilepsy, at least one-year seizure-free, across three academic institutions. This included a semi-structured interview script assessing attitudes towards seizures, ASMs, and ASM discontinuation.</div></div><div><h3>Results</h3><div>We interviewed 32 participants. Factors supporting ASM discontinuation included current side effects (e.g., dizziness, sedation), concern regarding long-term adverse effects, teratogenicity, inconvenience from taking and refilling prescriptions, feeling like seizure freedom demonstrated that they were ‘cured’, or low concern regarding seizure consequences. However, many reasons supported continued treatment, e.g., fear of seizures and their psychosocial consequences, little perceived downside to taking ASMs, or overall more substantial pros than cons. Patients noted that they might consider discontinuing ASMs if the medication was known to cause severe adverse effects (e.g., cancer), or if the doctor could guarantee seizure freedom post-discontinuation.</div></div><div><h3>Conclusion</h3><div>Numerous themes emerged including reasons favoring continued ASMs (e.g., fear of seizures and their psychosocial consequences, perceiving little downside to continued ASMs) but also many reasons against continued ASMs (e.g., side effects, inconvenience). Discussions surrounding how long to continue ASMs should be highly individualized given the heterogeneity of patient preferences regarding treatment and counseling.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"217 ","pages":"Article 107615"},"PeriodicalIF":2.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144322936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Latent renal tubular dysfunction in patients with epilepsy treated with valproic acid","authors":"Fumi Sawamura ,&nbsp;Jun Natsume ,&nbsp;Yuji Ito ,&nbsp;Takamasa Mitsumatsu ,&nbsp;Anna Shiraki ,&nbsp;Takeshi Suzuki ,&nbsp;Masahiro Kawaguchi ,&nbsp;Naoko Ishihara ,&nbsp;Toru Kato ,&nbsp;Motomasa Suzuki ,&nbsp;Tetsuo Kubota ,&nbsp;Tomoya Takeuchi ,&nbsp;Hiroyuki Yamamoto ,&nbsp;Tomohiko Nakata ,&nbsp;Hiroyuki Kidokoro","doi":"10.1016/j.eplepsyres.2025.107611","DOIUrl":"10.1016/j.eplepsyres.2025.107611","url":null,"abstract":"<div><h3>Background</h3><div>Valproic acid (VPA)-induced Fanconi’s syndrome has been reported, especially in patients with severe motor and intellectual disabilities, with carnitine deficiency identified as a possible factor. Latent renal tubular dysfunction (RTD) has also been noted in patients with epilepsy treated with VPA. We aimed to evaluate latent RTD in patients treated with and without VPA by examining urine RTD markers and their relationships with clinical variables.</div></div><div><h3>Methods</h3><div>Urine N<em>-</em>acetyl-β-D-glucosaminidase/creatinine (NAG/Cr) and β2-microglobulin/creatinine (BMG/Cr) were evaluated in 147 patients with childhood-onset epilepsy. NAG/Cr and BMG/Cr were compared between 90 patients treated with VPA (VPA group) and 57 patients treated with other anti-seizure medications (non-VPA group). Single correlations and multiple regression analyses were conducted between RTD markers and clinical variables in the VPA group.</div></div><div><h3>Results</h3><div>NAG/Cr was significantly higher in the VPA group than in the non-VPA group, whereas BMG/Cr was not significantly different. High or borderline NAG/Cr (&gt;4.0 IU/g*Cr) was seen in 85 (94 %) patients on VPA, and high NAG/Cr (≥10.0 IU/g*Cr) was seen in 21 (23 %) on VPA. In the VPA group, NAG/Cr was significantly correlated with free carnitine (FC), VPA dose adjusted for body weight, and duration of treatment with VPA. BMG/Cr was significantly correlated with the number of antiseizure medications. Multiple regression analysis showed that NAG/Cr was significantly correlated with FC.</div></div><div><h3>Conclusions</h3><div>Latent RTD was found in many patients on VPA, and elevated RTD markers were correlated with carnitine deficiency. Physicians should be aware of latent RTD in patients with childhood-onset epilepsy treated with VPA.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"216 ","pages":"Article 107611"},"PeriodicalIF":2.0,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144261532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demographic and regional trends in status epilepticus-related mortality among older adults in the United States (1999–2020): A nationwide retrospective analysis","authors":"Muhammad Hassan Waseem ,&nbsp;Zain Ul Abideen ,&nbsp;Fatima Hussain ,&nbsp;Zara Jamil ,&nbsp;Eman Alamgir ,&nbsp;Areeba Shams Sarwari ,&nbsp;Farwa Naveed ,&nbsp;Abdullah ,&nbsp;Fatima Kaleem Ahmed ,&nbsp;Muhammad Fawad Tahir ,&nbsp;Sania Aimen","doi":"10.1016/j.eplepsyres.2025.107610","DOIUrl":"10.1016/j.eplepsyres.2025.107610","url":null,"abstract":"<div><h3>Background and aims</h3><div>Because mortality data related to Status Epilepticus among the elderly in the United States are lacking, demographical and regional trends from 1999 to 2020 were analyzed.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional analysis of death certificates from the Center for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC-WONDER) database using crude and age-adjusted mortality rates (AAMR), followed by Jointpoint regression models yielding annual percentage changes (APCs) stratified to age, race/ethnicity, urban-rural classification, and region.</div></div><div><h3>Results</h3><div>It was observed that from 1999 to 2020, 17,883 deaths from status epilepticus among adults 65 and above were observed with a substantial decrease from 1999 to 2005 (APC: −4.6; 95 % CI: −8.1 to −0.9). This was then reversed with an increase till 2020 (APC:7.7; 95 % CI: 7–8.4). Moreover, it was observed that Black or African American mortality rates were significantly higher from 2007 to 2020 (APC of 7.99; 95 % CI, 7.03–8.96). Both Metropolitan 2006–2018 (APC: 8.21; 95 % CI, 7.37–9.05) and non-metropolitan areas from 2006 to 2020 (APC: 8.20; 95 % CI, 6.86–9.56) showed a rise in APC trends. The highest AAMRs occurred in South Carolina (AAMR: 97.5) followed by Kentucky (AAMR: 30.4) with the Southern region exhibiting the highest AAMR at 2.2.</div></div><div><h3>Conclusion</h3><div>The study reveals a significant increase in mortality rates from status epilepticus among the elderly, particularly within Black or African American communities and the Southern United States. These findings underscore the urgent need for targeted public health strategies to address and mitigate these growing disparities.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"216 ","pages":"Article 107610"},"PeriodicalIF":2.0,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144272007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep brain stimulation for epilepsy: A systematic review and meta-analysis of randomized and non-randomized studies of thalamic targeting","authors":"Jasneet Kaur Dhaliwal ,&nbsp;Michelle Ruiz-Perez ,&nbsp;Aswin Chari ,&nbsp;Rory J. Piper ,&nbsp;Martin M. Tisdall ,&nbsp;Michael Hart","doi":"10.1016/j.eplepsyres.2025.107607","DOIUrl":"10.1016/j.eplepsyres.2025.107607","url":null,"abstract":"<div><h3>Introduction</h3><div>Deep Brain Stimulation (DBS) of the thalamus for drug-resistant epilepsy (DRE) is an emerging treatment modality. This systematic review and meta-analysis sought to evaluate the efficacy of stimulating different targets within the thalamus.</div></div><div><h3>Methods</h3><div>A systematic search of four databases was conducted. Rates for overall seizure reduction (SR), responder rate (RR ≥50 % SR), and seizure freedom (SF) were evaluated at a minimum time point of 12 months post-stimulation commencement in the anterior (ANT) and centro-median (CMN) thalamic nuclei. Subgroup analyses for a minimum 24 months follow up, sensitivity analyses, and funnel plots to assess for publication bias were also performed. Risk of bias was assessed using the ROBINS-I tool.</div></div><div><h3>Results</h3><div>Fourty-nine articles met the inclusion criteria. The mean seizure reduction (SR) across 21 studies was 62.31 % (95 % CI: 55.99–68.62, p &lt; 0.01). Specifically, SR was 64.28 % for ANT (95 % CI: 57.55–71.01, p &lt; 0.01) and 69.11 % for CMN (95 % CI: 58.14–80.09, p &lt; 0.01). Meta-analyses of 41 ANT studies and 12 CMN studies reported a response rate (RR) of 61.51 % (95 % CI: 54.11–68.9, p &lt; 0.01) and 69.09 % (95 % CI: 54.01–84.16, p &lt; 0.01), respectively. Overall seizure freedom (SF) was 3.57 % % for ANT (95 % CI: 1.86–5.28, p = 0.45) and 1.32 % for CMN(95 % CI: 0–4.45, p = 0.81). For ANT, RR was 67.63 % (95 % CI: 61.04–74.23) for follow-up periods longer than 24 months, and 44.05 % (95 % CI: 26.73–61.38) for periods shorter than 24 months. The SF rate for ANT was 3 % (95 % CI: 1–4 %) for follow-up under 12 months. For CMN, RR was 70 % (95 % CI: 53–87 %) for periods over 24 months, and 68 % (95 % CI: 31–100 %) for periods under 24 months. The SF rate for CMN was 1 % (95 % CI: 0–4 %) for periods under 12 months. There was no strong evidence of publication bias based on funnel plot analysis, and results were consistent across sensitivity analyses. Insufficient data precluded meta-analysis for other nuclei.</div></div><div><h3>Conclusion</h3><div>These findings demonstrate efficacy of ANT and CMN DBS for patients with DRE, defined by responder rate and seizure reduction. Further research is required to optimize patient selection, predict individual response, and assess non-seizure related outcomes.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"216 ","pages":"Article 107607"},"PeriodicalIF":2.0,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144272004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}