Efficacy and quality of life outcomes in deep brain stimulation for epilepsy: A meta-analysis and systematic review

Drug-resistant epilepsy (DRE) remains a debilitating condition for those affected. This meta-analysis evaluates the effectiveness of Deep Brain Stimulation (DBS) as a neuromodulatory treatment option in improving seizure control and quality of life (QOL) in epilepsy.

PubMed, EMBASE (Elsevier), CiNAHL, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Scopus, and Web of Science were searched for articles from their inception to August 2024 by two independent reviewers using the Preferred Reporting items for Systematic Reviews and Meta-analysis (PRISMA) system. The review was registered prospectively with PROSPERO (CRD42023463358).

From 756 screened studies, 25 met eligibility criteria, comprising 480 patients with DRE undergoing DBS. Short-term follow-up showed that 41.6% achieved ≥50% seizure reduction at 3-6 months, increasing to 63% at ≥1 year. The pooled SUDEP proportion was 1%. Pooled mean QOLIE-31 scores were 47.59 at baseline, 56.11 at 3 months, 58.55 at 6 months, and 50.11 at ≥1 year, representing time-specific estimates derived from different study samples. The mean improvements at 3 and 6 months (+8.52 and +10.96) exceeded the minimal clinically important difference of 5 points.

DBS reduces seizure burden and yields early improvements in QOL among patients with DRE, with pooled QOLIE-31 estimates suggesting clinically meaningful gains in the early postoperative period. However, later timepoint estimates were more variable and should be interpreted cautiously, as they do not represent longitudinal trajectories within the same patients. These findings support DBS as an effective therapeutic option and highlight the need for future studies to optimize patient selection and long-term outcomes.