{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T21:49:48Z","timestamp":1792273788693,"version":"4.4.0"},"reference-count":25,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T00:00:00Z","timestamp":1774656000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T00:00:00Z","timestamp":1774656000000},"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":["Epilepsia"],"published-print":{"date-parts":[[2026,7]]},"abstract":"Abstract<\/jats:title>\n \n Objective<\/jats:title>\n This study was undertaken to evaluate the efficacy and safety of deep brain stimulation (DBS) of the anterior nucleus of the thalamus (ANT) compared with best medical treatment (BMT) in patients with drug\u2010resistant epilepsy (DRE).<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n This randomized, open\u2010label, phase 3 controlled trial was conducted across 14 specialized epilepsy and DBS centers. Eligible participants were adults with focal or multifocal DRE who had previously failed vagus nerve stimulation (VNS). Sixty\u2010one patients were randomized 1:1 either to receive continuous bilateral ANT\u2010DBS (\n n<\/jats:italic>\n \u2009=\u200930) or to continue BMT, including VNS (\n n<\/jats:italic>\n \u2009=\u200931), for 12\u2009months. Afterward, patients in the BMT group were offered delayed ANT\u2010DBS and followed for an additional year. The primary outcome was the change in monthly severe seizure frequency (defined on the modified Chalfont Scale) at 12\u2009months. Safety outcomes were also recorded.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among 67 screened patients, 61 were enrolled. At 12\u2009months, median seizure reduction was greater in the DBS group (\u221244%, interquartile range [IQR] = \u221267 to 0) versus the BMT group (\u22126%, IQR = \u201356 to 20;\n p<\/jats:italic>\n \u2009=\u2009.09); 44.5% of patients in the DBS group achieved a \u226550% reduction in seizure frequency compared to 27% in the BMT group. Within\u2010group analyses showed significant seizure reductions in the DBS group at both 12\u2009months (\u221244%,\n p<\/jats:italic>\n \u2009<\u2009.001) and 24\u2009months (\u221246%,\n p<\/jats:italic>\n \u2009<\u2009.001), as well as in the delayed DBS group at 12\u2009months (\u221236%, IQR = \u201373 to \u22124;\n p<\/jats:italic>\n \u2009<\u2009.001). No significant differences in quality of life were observed between groups, and no major DBS\u2010related adverse events were reported.\n <\/jats:p>\n <\/jats:sec>\n \n Significance<\/jats:title>\n Our study suggests a potential benefit rather than demonstrating superiority of ANT\u2010DBS over medical therapy. However, within\u2010group improvements and favorable safety profile support the use of ANT\u2010DBS as a palliative treatment option in patients with DRE who have failed VNS.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/epi.70211","type":"journal-article","created":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T10:34:41Z","timestamp":1774694081000},"page":"3318-3330","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Deep brain stimulation of the thalamus for intractable epilepsy (FRANCE study): A randomized clinical trial"],"prefix":"10.1002","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7930-1476","authenticated-orcid":false,"given":"St\u00e9phan","family":"Chabard\u00e8s","sequence":"first","affiliation":[{"name":"Neurosurgery Department Grenoble Alpes University, Grenoble Alpes University Hospital Grenoble France"},{"name":"Grenoble Alpes University, Commissariat \u00e0 l energie Atomique\u2010Clinatec Grenoble France"},{"name":"Grenoble Alpes University, Inserm, U1216, Grenoble Institut Neurosciences Grenoble France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1678-0297","authenticated-orcid":false,"given":"Fabrice","family":"Bartolomei","sequence":"additional","affiliation":[{"name":"Asssistance Publique Hopitaux de Marseille, Epileptology and Cerebral Rhythmology, Timone Hospital Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anca","family":"Nica","sequence":"additional","affiliation":[{"name":"University of Rennes, Inserm, LTSI\u2010U1099 Rennes France"},{"name":"\u201cVan Gogh\u201d Epilepsy Surgery Unit, Neurology Department, CIC 1414 University Hospital Rennes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8341-4887","authenticated-orcid":false,"given":"Claire","family":"Haegelen","sequence":"additional","affiliation":[{"name":"University of Rennes, Inserm, LTSI\u2010U1099 Rennes France"},{"name":"\u201cVan Gogh\u201d Epilepsy Surgery Unit, Neurology Department, CIC 1414 University Hospital Rennes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorella","family":"Minotti","sequence":"additional","affiliation":[{"name":"Neurology Department Grenoble Alpes University, Grenoble Alpes University Hospital Grenoble France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9660-4850","authenticated-orcid":false,"given":"Brigitte","family":"Piallat","sequence":"additional","affiliation":[{"name":"Grenoble Alpes University, Inserm, U1216, Grenoble Institut Neurosciences Grenoble France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chrystele","family":"Mosca","sequence":"additional","affiliation":[{"name":"Neurology Department Grenoble Alpes University, Grenoble Alpes University Hospital Grenoble France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandrine","family":"Massicot","sequence":"additional","affiliation":[{"name":"Grenoble Alpes University, Inserm, CNRS, Grenoble INP, TIMC Grenoble France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvain","family":"Rheims","sequence":"additional","affiliation":[{"name":"Department of Functional Neurology and Epileptology Hospices Civils de Lyon and Lyon 1 University Bron France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Guenot","sequence":"additional","affiliation":[{"name":"Department of Functional Neurosurgery Hospices Civils de Lyon, Pierre Wertheimer Neurological Hospital Bron France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Cuny","sequence":"additional","affiliation":[{"name":"Neurochirurgie B. CHU de Bordeaux Bordeaux France"},{"name":"Institut des Maladies Neurod\u00e9g\u00e9n\u00e9ratives, CNRS UMR5293 Universit\u00e9 de Bordeaux Bordeaux France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7268-7479","authenticated-orcid":false,"given":"J\u00e9rome","family":"Aupy","sequence":"additional","affiliation":[{"name":"Department of Neurology, Section of Epileptology Bordeaux University Hospital Center Bordeaux France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis","family":"Maillard","sequence":"additional","affiliation":[{"name":"Service de Neurologie, Centre de R\u00e9f\u00e9rence des \u00c9pilepsies Rares, CHRU de Nancy; CNRS, IMoPA, Universit\u00e9 de Lorraine Nancy France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Colnat\u2010Coulbois","sequence":"additional","affiliation":[{"name":"Service de Neurochirurgie Universit\u00e9 de Lorraine, CHRU Nancy 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