{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T08:42:29Z","timestamp":1792226549819,"version":"4.4.0"},"reference-count":17,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"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":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The optimal pre\u2010implantation evaluation and surgical targeting strategies for responsive neurostimulation (RNS) in patients with unresectable, drug\u2010resistant focal epilepsy continue to be debated. Although stereo\u2010electroencephalography (sEEG) is central to characterizing the seizure\u2010onset zone, its role in preoperative testing for neuromodulation remains undefined. We examined whether sEEG\u2010guided targeting for RNS implantation confers seizure\u2010reduction benefit compared with RNS implantation without sEEG.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed patients who underwent RNS implantation at our institution in 2015\u20132024. Patients were propensity score\u2013matched based on demographics and epilepsy characteristics to create balanced groups of patients with and without prior sEEG. The primary outcome measure was seizure reduction as a percent change from baseline frequency, determined using linear regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 99 patients (median\u2009\u00b1\u2009standard error [SE] follow\u2010up 45.3\u2009\u00b1\u20092.9\u2009months), 78 (79%) underwent sEEG monitoring before RNS implantation and 21 (21%) did not. Most patients (62%) had no prior interventions for epilepsy and had non\u2010lesional epilepsy (75%). Mean seizure reduction at last follow\u2010up was 72.4%\u2009\u00b1\u200929.3%. There were 21 patients in each propensity\u2010matched group. The use of preoperative sEEG was not associated with greater seizure reduction in the original (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.835) and propensity score\u2013matched cohorts (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.914). In the unmatched cohort, female sex (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u200916.7,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.006,) older age (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u2009.55,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.027), thalamic RNS stimulation (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u200918.0,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.030), and follow\u2010up duration (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u2009.2,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.029) were associated with greater seizure reduction on linear regression. Subgroup analyses among epilepsy subtypes (bitemporal, temporal, or extratemporal) found no statistically significant differences in seizure reduction.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>In a climate of growing delays in epilepsy care, we did not observe differences in RNS efficacy with or without prior sEEG monitoring in patients with unilateral or bilateral temporal lobe epilepsy, temporal\u2010plus epilepsy, and extratemporal epilepsy. Although prospective data are needed to investigate the relative benefit of preoperative sEEG use, these findings may help guide patient selection and optimize definitive surgical planning.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epi.70377","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T14:38:41Z","timestamp":1784039921000},"page":"5179-5188","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Stereo\u2010electroencephalography\u2013guided responsive neuromodulation: A propensity\u2010matched cohort study"],"prefix":"10.1002","volume":"67","author":[{"given":"David","family":"Botros","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center University of Utah  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3459-5698","authenticated-orcid":false,"given":"Julian","family":"Brown","sequence":"additional","affiliation":[{"name":"Spencer Fox Eccles School of Medicine, University of Utah  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John D.","family":"Rolston","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Mass General Brigham, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul A.","family":"House","sequence":"additional","affiliation":[{"name":"Neurosurgical Associates, LLC  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir","family":"Arain","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Utah  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Jensen","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Utah  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blake","family":"Newman","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Utah  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Utah  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sindhu","family":"Richards","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Utah  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5140-0619","authenticated-orcid":false,"given":"Angela","family":"Peters","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Utah  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shervin","family":"Rahimpour","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center University of Utah  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben","family":"Shofty","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center University of Utah  Salt Lake City Utah 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