{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T18:06:22Z","timestamp":1787162782838,"version":"build-2736575974"},"reference-count":43,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T00:00:00Z","timestamp":1778803200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T00:00:00Z","timestamp":1778803200000},"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":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Lennox\u2013Gastaut syndrome (LGS) is a severe developmental and epileptic encephalopathy (DEE) characterized by multiple seizure types and high resistance to antiseizure medication (ASM), often necessitating nonpharmacologic therapies, including neuromodulation. Responsive neurostimulation (RNS), a closed\u2010loop brain\u2010responsive neuromodulation device, has emerged as an adjunctive treatment option for drug\u2010resistant epilepsy (DRE), but evidence on its safety and effectiveness in LGS remains limited. This study examines real\u2010world outcomes of RNS therapy in patients with LGS\u2010associated DRE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective multicenter study included patients with LGS who underwent RNS implantation before December 2024 across four Level 4 National Association of Epilepsy Centers (NAEC) in the United States. Demographic, clinical, surgical, and outcome data were systematically collected using a standardized case report form and analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirty\u2010seven patients met inclusion criteria. At the time of RNS implantation, 95% of patients were pediatric (mean age 12.9\u2009years, range 3.6\u201328.8) with a median follow\u2010up of 24.5\u2009months. All patients had generalized tonic seizures; additional seizure types included tonic\u2013clonic (62%), atonic (50%), atypical absence (19%), and other (54%). The pooled responder rate (\u226550% seizure reduction) was 62%, including 10% with \u226590% reduction. Thalamic\u2010only stimulation of the bilateral centromedian nucleus (CMN) was the most common electrode configuration (76%), followed by cortico\u2010thalamic targeting to the CMN and bi\u2010frontal regions (18%). Among responders, 83% received thalamic\u2010only CMN stimulation. ASM reduction occurred in 10% of patients. Adverse events were reported in 13%, primarily implant\u2010related infections, with 4 patients requiring explantation. Stimulation\u2010related side effects occurred in 27% and resolved with programming adjustments in 80%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>RNS targeting thalamic and cortico\u2010thalamic networks resulted in seizure reduction in the majority of this predominantly pediatric LGS cohort. Therapy was generally well\u2010tolerated with few serious adverse events, supporting its potential role as an adjunctive treatment option for DRE in LGS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Plain Language Summary<\/jats:title>\n                    <jats:p>Lennox\u2013Gastaut syndrome is a severe form of epilepsy that is often hard to control with medications. This study evaluated responsive neurostimulation (RNS), an implanted device that monitors brain activity and delivers electrical stimulation to help stop seizures before they spread. In 37 mostly pediatric patients, about 60% had their seizures reduced by at least half, and some improved even more. The treatment was generally safe, and most side effects could be managed by adjusting the device.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epi4.70283","type":"journal-article","created":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T11:47:43Z","timestamp":1778845663000},"page":"1244-1254","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Real\u2010world outcomes of responsive neurostimulation in patients with Lennox\u2013Gastaut syndrome: A multicenter retrospective study"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3431-1507","authenticated-orcid":false,"given":"Shanna M.","family":"Swartwood","sequence":"first","affiliation":[{"name":"Division of Pediatric Neurology, Department of Pediatrics University of Utah School of Medicine  Salt Lake City Utah USA"},{"name":"Intermountain Healthcare  Salt Lake City Utah 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L.","family":"Geffrey","sequence":"additional","affiliation":[{"name":"Department of Neurology Massachusetts General Hospital  Boston Massachusetts USA"},{"name":"Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2620-7387","authenticated-orcid":false,"given":"Robert Mark","family":"Richardson","sequence":"additional","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts USA"},{"name":"Department of Neurosurgery Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8318-2924","authenticated-orcid":false,"given":"Hiroki","family":"Nariai","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurology, Department of Pediatrics, UCLA Mattel Children's Hospital David Geffen School of Medicine  Los Angeles California 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