{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T14:14:37Z","timestamp":1785248077953,"version":"3.55.0"},"reference-count":18,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T00:00:00Z","timestamp":1762992000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T00:00:00Z","timestamp":1762992000000},"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 Open"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>The management of drug\u2010resistant epilepsy (DRE) in the pediatric population using neurostimulation of the centromedian (CM) nucleus of the thalamus (CMN) has been reported to be effective and safe. We present a case series of pediatric patients treated with responsive neurostimulation (RNS) and report on contact localization in relation to preliminary outcomes, specifically seizure reduction rates. Thirteen pediatric patients treated with RNS underwent direct targeting of the CMN based on Magnetization\u2010Prepared 2 Rapid Gradient\u2010Echo (MP2RAGE) scans, using ClearPoint neuronavigation. The implanted electrodes were co\u2010registered to a probabilistic anatomical model of the thalamic nuclei (Freesurfer) for secondary confirmation of contact localization. Ten out of the 12 patients with extra\u2010temporal multifocal or generalized DRE (83.3%) had over 50% reduction in seizures, benefiting from an 80.4% seizure reduction rate. The average follow\u2010up interval was 25.2\u2009months, with no patients experiencing stimulation\u2010related side effects. The analysis of post\u2010operative images revealed that out of the 24 CM\u2010processed electrodes, 23 (95.8%) had at least two contacts in the nucleus, based on patient\u2010specific segmentation of the thalamus. The preliminary outcomes suggest a robust response to central neurostimulation and no stimulation\u2010related side effects in pediatric patients suffering from multifocal or generalized DRE when implementing high\u2010accuracy direct targeting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Plain Language Summary<\/jats:title>\n                    <jats:p>We are reporting our experience in the management of the most challenging types of pediatric epilepsy, involving seizures originating from multiple and\/or poorly defined brain areas. We surgically implanted a responsive neurostimulation device (RNS) in central areas of the brain that function as connection hubs between different brain regions. These devices are designed to detect early signs of abnormal brain\u00a0activity, and respond with electrical pulses to prevent progression to clinical seizures. Using our approach, we reduced the seizure rates by an average of 80% in 83% of the pediatric patients who received this treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epi4.70181","type":"journal-article","created":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T14:34:18Z","timestamp":1763044458000},"page":"322-331","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Centromedian nucleus targeting in the pediatric population treated with thalamic responsive neurostimulation for drug\u2010resistant epilepsy"],"prefix":"10.1002","volume":"11","author":[{"given":"Marian Michael","family":"Bercu","sequence":"first","affiliation":[{"name":"Division of Pediatric Neurosurgery Helen DeVos Children's Hospital, Corewell Health  Grand Rapids Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bahram Sarvi","family":"Zargar","sequence":"additional","affiliation":[{"name":"Department of Neuroscience Helen DeVos Children's Hospital, Corewell Health  Grand Rapids Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn E.","family":"Spykman","sequence":"additional","affiliation":[{"name":"Department of Neuroscience Helen DeVos Children's Hospital, Corewell Health  Grand Rapids Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabe","family":"Heredia","sequence":"additional","affiliation":[{"name":"Department of Imaging Corewell Health  Grand Rapids Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alon Y.","family":"Mogilner","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery NYU Grossman School of Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angel W.","family":"Hernandez","sequence":"additional","affiliation":[{"name":"Division of Neurology Johns Hopkins All Children's Hospital  St. Petersburg Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjay E.","family":"Patra","sequence":"additional","affiliation":[{"name":"Division of Neurological Surgery, Department of Clinical Neuroscience Corewell Health  Grand Rapids Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David E.","family":"Burdette","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Clinical Neuroscience Corewell Health  Grand Rapids Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Ferrari","sequence":"additional","affiliation":[{"name":"Department of Neuroscience Helen DeVos Children's Hospital, Corewell Health  Grand Rapids Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,13]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/WNP.0000000000001060"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.3171\/2023.2.JNS222116"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.18070"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.3171\/2024.2.PEDS23531"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.17883"},{"key":"e_1_2_12_7_1","volume-title":"Atlas for Stereotaxy of the human brain","author":"Schaltenbrand G","year":"1977"},{"key":"e_1_2_12_8_1","first-page":"1","article-title":"Optimizing indirect targeting of the centromedian nucleus for deep brain stimulation by incorporating third ventricular anatomy","volume":"142","author":"Singh H","year":"2024","journal-title":"J 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