{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T06:33:13Z","timestamp":1793860393644,"version":"4.6.1"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2021,7,31]],"date-time":"2021-07-31T00:00:00Z","timestamp":1627689600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurosurg.","NEUROS"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>The Food and Drug Administration approved the deep brain stimulation of the anterior nucleus of the thalamus (ANT-DBS) as an adjunctive therapy for drug-resistant epilepsy (DRE) in the United States in 2018. The DBS Therapy for Epilepsy Post-Approval Study is further evaluating the safety and effectiveness of ANT-DBS among different patients\u2019 groups. For this study, devices for vagus nerve stimulation (VNS) must be removed prior to enrolment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To investigate the outcomes of concomitant ANT-DBS and VNS treatment for DRE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>A retrospective analysis was performed for 33 patients who underwent ANT-DBS using previous VNS to define distinct subgroups: standard ANT-DBS (9 subjects), ANT-DBS with functional VNS (12 subjects), and ANT-DBS with the VNS implantable pulse generator explanted or turned off at the time of the DBS (12 subjects). Effectiveness and safety data were analyzed across the whole population and among subgroups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>A mean decrease in seizure frequency of 55% was observed after a mean follow-up of 25.5 mo. Approximately 67% of patients experienced \u226550% reduction in seizure frequency. Seizure reduction percentage was not significantly different among groups. Approximately 50% of subjects with no appreciable improvement and 75% of those who showed benefit after VNS (including improvement in seizure frequency, seizure severity, and seizure duration or quality of life) achieved a seizure reduction \u226550% after ANT-DBS surgery. There were no complications related to concomitant VNS and ANT-DBS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>ANT-DBS for DRE provides excellent results despite previous and ongoing VNS therapy. Removal of VNS does not appear to be necessary before ANT-DBS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/neuros\/nyab253","type":"journal-article","created":{"date-parts":[[2021,6,26]],"date-time":"2021-06-26T15:09:58Z","timestamp":1624720198000},"page":"686-694","source":"Crossref","is-referenced-by-count":38,"title":["Anterior Nucleus of the Thalamus Deep Brain Stimulation with Concomitant Vagus Nerve Stimulation for Drug-Resistant Epilepsy"],"prefix":"10.1227","volume":"89","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7110-4785","authenticated-orcid":false,"given":"Veronica","family":"Parisi","sequence":"first","affiliation":[{"name":"Department of Neurosurgery and Gamma Knife Radiosurgery, IRCCS San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian Nils","family":"Lundstrom","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panagiotis","family":"Kerezoudis","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Luis","family":"Alcala Zermeno","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory A","family":"Worrell","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8087-7870","authenticated-orcid":false,"given":"Jamie J","family":"Van Gompel","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,10]]},"reference":[{"issue":"7","key":"bib1-20231011","first-page":"392","article-title":"Overview of drugs used for epilepsy and seizures: etiology, diagnosis, and treatment","volume":"35","author":"Goldenberg","year":"2010","journal-title":"P T"},{"issue":"1","key":"bib2-20231011","doi-asserted-by":"crossref","first-page":"14","DOI":"10.14581\/jer.19002","article-title":"Antiepileptic drug therapy in patients with drug-resistant epilepsy","volume":"9","author":"Park","year":"2019","journal-title":"J Epilepsy Res"},{"issue":"5","key":"bib3-20231011","doi-asserted-by":"crossref","first-page":"1188","DOI":"10.1093\/brain\/awh449","article-title":"Long-term seizure outcomes following epilepsy surgery: a systematic review and meta-analysis","volume":"128","author":"T\u00e9llez-Zenteno","year":"2005","journal-title":"Brain"},{"issue":"7","key":"bib4-20231011","doi-asserted-by":"crossref","first-page":"1140","DOI":"10.1016\/j.clinthera.2020.05.017","article-title":"Neuromodulation for the treatment of epilepsy: a review of current approaches and future directions","volume":"42","author":"Davis","year":"2020","journal-title":"Clin Ther"},{"issue":"11","key":"bib5-20231011","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.1136\/jnnp-2013-307069","article-title":"Advances in epilepsy surgery","volume":"85","author":"Nowell","year":"2014","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"bib6-20231011","doi-asserted-by":"crossref","first-page":"601","DOI":"10.3389\/fneur.2019.00601","article-title":"Deep brain stimulation and drug-resistant epilepsy: a review of the literature","volume":"10","author":"Zangiabadi","year":"2019","journal-title":"Front Neurol"},{"issue":"2","key":"bib7-20231011","doi-asserted-by":"crossref","first-page":"E5","DOI":"10.3171\/2018.5.FOCUS18161","article-title":"Open-loop deep brain stimulation for the treatment of epilepsy: a systematic review of clinical outcomes over the past decade (2008-present)","volume":"45","author":"Zhou","year":"2018","journal-title":"Neurosurg Focus"},{"issue":"2","key":"bib8-20231011","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1212\/WNL.45.2.224","article-title":"A randomized controlled trial of chronic vagus nerve stimulation for treatment of medically intractable seizures. 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