Memory and mood outcomes after anterior thalamic stimulation for refractory partial epilepsy

Area of Science:

• Neuroscience
• Neurosurgery
• Neurology

Background:

• Bilateral deep brain stimulation (DBS) of the anterior nucleus of the thalamus (ANT) is an established epilepsy treatment.
• While generally safe and effective in reducing seizures, ANT-DBS may be associated with adverse events (AEs) such as memory problems and depression.

Purpose of the Study:

• To investigate the incidence of memory and depression AEs during the blinded phase of the SANTE study.
• To examine the relationship between these AEs and objective neurobehavioral measures, baseline characteristics, quality of life, and long-term outcomes.

Main Methods:

• Analysis of neurobehavioral AEs and neuropsychological data from the SANTE prospective randomized trial.
• Calculation of reliable change indices (RCIs) for memory and mood measures.
• Examination of associations between AEs, RCIs, demographic and seizure variables, and long-term neurobehavioral outcomes.

Main Results:

• No significant cognitive decline or worsening depression scores were observed during the blinded phase or at 7-year follow-up.
• Executive functions and attention scores improved at 7 years.
• Memory and depression AEs were not linked to objective neurobehavioral changes, long-term outcomes, or quality of life.

Conclusions:

• Subjective memory and depression AEs in a minority of patients receiving ANT-DBS were not associated with objective neurobehavioral worsening.
• Neuropsychological monitoring for memory and depression is recommended due to higher AE incidence in the active stimulation group.