Cognitive change after DBS in refractory epilepsy: A randomized-controlled trial.

Area of Science:

• Neurology
• Neurosurgery
• Cognitive Neuroscience

Background:

• Refractory epilepsy affects many patients, with limited treatment options.
• Deep brain stimulation of the anterior thalamic nucleus (ANT-DBS) is a potential therapy for refractory epilepsy.
• The impact of ANT-DBS on cognitive functions requires further investigation.

Purpose of the Study:

• To investigate cognitive changes in patients with refractory epilepsy undergoing ANT-DBS.
• To explore the relationship between stimulation duration and cognitive effects.
• To determine if changes in seizure frequency correlate with cognitive improvements.

Main Methods:

• 18 patients with refractory epilepsy received bilateral ANT electrodes.
• Patients were randomized to ANT-DBS ON or OFF for 6 months, followed by an open-label phase.
• Neuropsychological assessments were performed at baseline, 6 months, and 12 months.

Main Results:

• ANT-DBS showed limited effects on formal cognitive tests, with changes in motor speed and sustained attention.
• Patients reported reduced executive dysfunction symptoms after 12 months of stimulation.
• Improved seizure frequency was associated with better verbal learning.

Conclusions:

• ANT-DBS has minimal impact on cognitive functioning in epilepsy patients after 6-12 months.
• ANT-DBS may positively influence executive function and verbal learning.
• Limited evidence supports an association between seizure frequency reduction and cognitive gains.