Long-term effectiveness of ANT-DBS in epilepsy confirmed

The benefit and safety of deep brain stimulation (DBS) of the anterior nucleus of the thalamus (ANT) in drug-resistant epilepsy patients was confirmed in a real-world setting. Two years following implantation, seizure frequency decreased by 33%. Patients without cognitive impairment may benefit more from this therapy.

The randomised, double-blind SANTE trial previously established the efficacy of ANT-DBS in patients with drug-resistant epilepsy [1]. ANT-DBS is an established third-line therapy for patients with drug-resistant focal epilepsy, but real-world data remains scarce. The Medtronic Registry for Epilepsy (MORE; NCT01521754) is an open-label, observational study to evaluate the long-term effectiveness, safety, and performance of ANT-DBS in this patient group in routine clinical practice [2].

Participants were 191 adult patients with focal drug-resistant epilepsy from 13 European countries. Seizure frequency, health-related quality of life (QOLIE-31), depression, and safety at 2 years were reported. Both prospective and retrospective clinical data were obtained and analysed. The 170 participants included in this interim analysis had a mean age of 36 years, 73 (43%) were women, and 65 (38%) reported cognitive impairment at baseline.

After 2 years, median monthly seizure frequency had progressively decreased by 33.1% (P<0.0001). Factors influencing seizure frequency reduction included seizure type, absence of cognitive impairment, and site implant volume. QOLIE-31 simultaneously increased by a median of 2 points. Depression severity did not significantly alter. Among the most frequent adverse events were new or worsening seizures (16%), memory impairment (15%), and depression (13%).

1. Fisher R, et al. Epilepsia 2010;51:899-908.
2. Peltola JT, et al. Deep brain stimulation of the ANT for drug resistant epilepsy in a real-world setting: MORE registry 2-year results. OPR-152, EAN 2021 Virtual Congress, 19–22 June.

 

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Posted on 18 August 202117 May 2024