{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T09:51:02Z","timestamp":1781776262034,"version":"3.54.5"},"reference-count":34,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epileptic Disorders"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Deep brain stimulation (DBS) targeting the anterior nucleus of the thalamus (ANT), centromedian nucleus (CM), and medial pulvinar nucleus (PuM) has emerged as a neuromodulatory intervention for adults with drug\u2010resistant epilepsy (DRE). Despite growing clinical experience, no pooled analysis has integrated outcomes across all three thalamic targets. A PRISMA\u2010compliant systematic search was conducted across PubMed, EMBASE, and Cochrane databases (January 2000\u2013December 2025). Studies reporting seizure frequency reduction following thalamic DBS in \u22654 adults with DRE and \u22656\u2009months of follow\u2010up were included. Pooled descriptive statistics and weighted mean analyses were calculated within each target separately; subgroup comparisons by seizure onset zone and epilepsy classification were performed within each nucleus. Nineteen studies (651 patients) met inclusion criteria: ten ANT (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009551), seven CM (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200989), and two PuM (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200911). Weighted mean seizure frequency reductions were 48.7% (ANT), 71.4% (CM), and 62.0% (PuM). Responder rates (\u226550% reduction) were 48.7% (ANT), 76.2% (CM), and 60.0% (PuM). ANT DBS showed progressive improvement from year one (33%\u201341% reduction) through year five (56%\u201369% reduction). Temporal lobe origin predicted superior ANT outcomes. CM DBS was most effective for generalized epilepsy syndromes, including Lennox\u2013Gastaut syndrome. PuM DBS yielded promising results for posterior quadrant and temporal\u2010plus epilepsy. Adverse events were target\u2010specific, including depression and memory impairment (ANT), postoperative drowsiness (CM), and hemorrhagic complications (PuM). No stimulation\u2010related mortality occurred. Thalamic DBS provides durable seizure reduction across three nuclear targets, with efficacy varying by epilepsy classification and seizure onset zone. ANT DBS has Class I evidence supporting its use in focal epilepsies, particularly temporal lobe origin. CM DBS shows strong preliminary efficacy for generalized epilepsies, warranting larger randomized trials. PuM DBS requires prospective validation. Head\u2010to\u2010head comparative trials are needed before individualized target selection recommendations can be made.\n                  <\/jats:p>","DOI":"10.1002\/epd2.70256","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T13:02:33Z","timestamp":1777381353000},"page":"661-677","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Seizure outcomes after thalamic deep brain stimulation in drug\u2010resistant epilepsy: How electrode location, device platform, and epilepsy subtype drive response\u2014A\u00a0systematic review with pooled analysis"],"prefix":"10.1002","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-7576-1142","authenticated-orcid":false,"given":"Margil","family":"Ranpariya","sequence":"first","affiliation":[{"name":"Department of Neurology University at Buffalo  Buffalo New York USA"},{"name":"Jacobs School of Medicine and Biomedical Sciences  Buffalo New\u00a0York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gurleen","family":"Kaur","sequence":"additional","affiliation":[{"name":"Department of Neurology University at Buffalo  Buffalo New York USA"},{"name":"Jacobs School of Medicine and Biomedical Sciences  Buffalo New\u00a0York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Schwandt","sequence":"additional","affiliation":[{"name":"Department of Neurology University at Buffalo  Buffalo New York USA"},{"name":"Jacobs School of Medicine and Biomedical Sciences  Buffalo New\u00a0York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology University at Buffalo  Buffalo New York USA"},{"name":"Jacobs School of Medicine and Biomedical Sciences  Buffalo New\u00a0York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osman","family":"Farooq","sequence":"additional","affiliation":[{"name":"Department of Neurology University at Buffalo  Buffalo New York USA"},{"name":"Jacobs School of Medicine and Biomedical Sciences  Buffalo New\u00a0York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexus","family":"Ludwig","sequence":"additional","affiliation":[{"name":"Department of Neurology University at Buffalo  Buffalo New York USA"},{"name":"Jacobs School of Medicine and Biomedical Sciences  Buffalo New\u00a0York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Imtiaz","family":"Nazam","sequence":"additional","affiliation":[{"name":"Department of Neurology University at Buffalo  Buffalo New York USA"},{"name":"Jacobs School of Medicine and Biomedical Sciences  Buffalo New\u00a0York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hussain","family":"Shallwani","sequence":"additional","affiliation":[{"name":"Jacobs School of Medicine and Biomedical Sciences  Buffalo New\u00a0York USA"},{"name":"Department of Neurosurgery University at Buffalo  Buffalo New\u00a0York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Glover","sequence":"additional","affiliation":[{"name":"Department of Neurology University at Buffalo  Buffalo New York USA"},{"name":"Jacobs School of Medicine and Biomedical Sciences  Buffalo New\u00a0York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,28]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2010.02536.x"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200002033420503"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.220"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eplepsyres.2010.02.007"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.3171\/2011.7.JNS11977"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3182302056"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000010154"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2014.59"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2019.00601"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneurpsyc.1937.02260220069003"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000436078.95856.56"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000001334"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000206887"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.18003"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.12352"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-211-33081-4_38"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2006.00593.x"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.26280"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.3171\/2022.2.JNS212237"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2006.00375.x"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awl151"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2024.1480819"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.18244"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/ane.13047"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1227\/NEU.0000000000001197"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2006.00898.x"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-025-04465-5"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-015-2498-1"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2018.00324"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2009.06.002"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2020.107354"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-025-57392-7"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.16895"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2020.08.015"}],"container-title":["Epileptic 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