{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T15:41:14Z","timestamp":1789486874713,"version":"build-2803163510"},"reference-count":50,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"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"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Surgical intervention is frequently considered for drug\u2010resistant focal structural epilepsy. However, the impact of early surgery on seizure control, cognitive performance, and quality of life (QoL) across drug\u2010sensitive and drug\u2010resistant patients remains incompletely characterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a prospective\u2013retrospective study on 214 patients with age &gt; 6\u2009years with focal structural epilepsy (focal cortical dysplasia type II, hippocampal sclerosis, low\u2010grade epilepsy\u2010associated tumors) stratified as: drug\u2010sensitive (DS,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200972) and drug\u2010resistant (DR,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009112) patients undergoing surgery, and drug\u2010resistant patients on pharmacological treatment (DRT,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200930). Cognitive function (including language, verbal and visuospatial memory, attention\/executive functions) and QoL (using the Quality of Life in Epilepsy Inventory [QOLIE] and 36\u2010Item Short Form Survey [SF\u201036] questionnaires) were assessed at baseline and 1\u2010year follow\u2010up in patient subgroups. Statistical analyses included chi\u2010square tests,\n                      <jats:italic>t<\/jats:italic>\n                      tests, analysis of variance (ANOVA), and multivariable regression models;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.05 was considered statistically significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The DS patients demonstrated superior rates of complete seizure freedom (86%) compared with DR patients (69%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.009). At baseline, DS patients exhibited significantly fewer cognitive deficits compared with DR and DRT patients (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.05). At the 1\u2010year follow\u2010up, no significant changes in neuropsychological performance were observed in any group, although a mild decline in verbal and\/or visuospatial memory performance was observed in DRT patients. In a subset of patients (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200959 adults) at baseline, DR and DRT patients reported significantly worse overall subjective QoL compared with DS patients (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.047 and\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.036, respectively). Longitudinal analysis revealed significant improvements in QoL among surgically treated patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>Early epilepsy surgery in symptomatic focal epilepsy yields excellent seizure outcomes, particularly in DS patients. Baseline preservation of cognitive function and QoL, together with the stability of these measures after surgery, suggests that timely surgery may help prevent deterioration in cognitive and psychosocial functioning. These findings support early referral for surgical evaluation in selected patients and highlight the need for larger studies with extended follow\u2010up, to confirm surgical outcome, long\u2010term neuropsychological, and patient\u2010reported benefits.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epi.70500","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T13:29:50Z","timestamp":1789478990000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["<scp>VENI<\/scp>\n                    ,\n                    <scp>VIDI<\/scp>\n                    ,\n                    <scp>VICI<\/scp>\n                    : The advantage of early epilepsy surgery in drug\u2010sensitive patients"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3876-030X","authenticated-orcid":false,"given":"Veronica","family":"Pelliccia","sequence":"first","affiliation":[{"name":"\u201cClaudio Munari\u201d Epilepsy Surgery Centre ASST Grande Ospedale Metropolitano Niguarda  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9968-7230","authenticated-orcid":false,"given":"Chiara","family":"Peretto","sequence":"additional","affiliation":[{"name":"\u201cClaudio Munari\u201d Epilepsy Surgery Centre ASST Grande Ospedale Metropolitano Niguarda  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4903-1196","authenticated-orcid":false,"given":"Laura","family":"Landolina","sequence":"additional","affiliation":[{"name":"\u201cClaudio Munari\u201d Epilepsy Surgery Centre ASST Grande Ospedale Metropolitano Niguarda  Milan Italy"},{"name":"IRCCS Istituto Delle Scienze Neurologiche di Bologna UOC Neuropsichiatria Dell'et\u00e0 Pediatrica  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0356-9273","authenticated-orcid":false,"given":"Andrea","family":"Roncadori","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Romagnolo per Lo Studio Dei Tumori (IRST) \u201cDino Amadori\u201d  Meldola Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8318-0382","authenticated-orcid":false,"given":"Francesca","family":"Gozzo","sequence":"additional","affiliation":[{"name":"\u201cClaudio Munari\u201d Epilepsy Surgery Centre ASST Grande Ospedale Metropolitano Niguarda  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-6184-1587","authenticated-orcid":false,"given":"Laura","family":"Castana","sequence":"additional","affiliation":[{"name":"\u201cClaudio Munari\u201d Epilepsy Surgery Centre ASST Grande Ospedale Metropolitano Niguarda  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9757-2061","authenticated-orcid":false,"given":"Piergiorgio","family":"d'Orio","sequence":"additional","affiliation":[{"name":"\u201cClaudio Munari\u201d Epilepsy Surgery Centre ASST Grande Ospedale Metropolitano Niguarda  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3961-0637","authenticated-orcid":false,"given":"Roberto","family":"Mai","sequence":"additional","affiliation":[{"name":"\u201cClaudio Munari\u201d Epilepsy Surgery Centre ASST Grande Ospedale Metropolitano Niguarda  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0948-354X","authenticated-orcid":false,"given":"Alessia","family":"Mingarelli","sequence":"additional","affiliation":[{"name":"\u201cClaudio Munari\u201d Epilepsy Surgery Centre ASST Grande Ospedale Metropolitano Niguarda  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8351-6608","authenticated-orcid":false,"given":"Maura","family":"Simioni","sequence":"additional","affiliation":[{"name":"Department of Brain and Behavioral Sciences University of Pavia  Pavia Italy"},{"name":"NeuroMI \u2010 Milan Center for Neuroscience  Milan Italy"},{"name":"Cognitive Neuropsychology Centre ASST Grande Ospedale Metropolitano Niguarda  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0537-586X","authenticated-orcid":false,"given":"Martina","family":"Gandola","sequence":"additional","affiliation":[{"name":"Department of Brain and Behavioral Sciences University of Pavia  Pavia Italy"},{"name":"NeuroMI \u2010 Milan Center for Neuroscience  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2143-2331","authenticated-orcid":false,"given":"Pina","family":"Scarpa","sequence":"additional","affiliation":[{"name":"NeuroMI \u2010 Milan Center for Neuroscience  Milan Italy"},{"name":"Cognitive Neuropsychology Centre ASST Grande Ospedale Metropolitano Niguarda  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5801-3443","authenticated-orcid":false,"given":"Ginevra","family":"Giovannelli","sequence":"additional","affiliation":[{"name":"Emergency Neurology Unit, Epilepsy Center Careggi Hospital  Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4683-6420","authenticated-orcid":false,"given":"Gabriella","family":"Bottini","sequence":"additional","affiliation":[{"name":"Department of Brain and Behavioral Sciences University of Pavia  Pavia Italy"},{"name":"NeuroMI 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