The effect of responsive neurostimulation (RNS) on neuropsychiatric and psychosocial outcomes in drug-resistant epilepsy

Tager, Dale; Panjeti-Moore, Deepa; Yang, Jimmy C.; Rivera-Cruz, Angélica; Loring, David W.; Staikova, Ekaterina; Block, Cady; Bullinger, Katie L.; Rodriguez-Ruiz, Andres A; Cabaniss, Brian T.; Winkel, Daniel; Bonilha, Leonardo; Willie, Jon T.; Gross, Robert E.; Drane, Daniel L.; Karakis, Ioannis

doi:10.1016/j.yebeh.2023.109207

Cited by 4 publications

(1 citation statement)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Neuropsychological outcomes following resective epilepsy surgery and neuromodulatory procedures are currently an area of active interest. New studies investigating the neuropsychological impacts of RNS are currently being reported [16]. However, there have been no head-to-head comparisons of RNS neuropsychological outcomes against other surgical interventions for epilepsy including anterior temporal lobectomy (ATL).…”

Section: Introductionmentioning

confidence: 99%

A Comparison of Neuropsychological Outcomes following Responsive Neurostimulation and Anterior Temporal Lobectomy in Drug-Resistant Epilepsy

O’Donnell,

Anderson,

Oleksy

et al. 2023

Brain Sciences

View full text Add to dashboard Cite

Neuropsychological outcomes following temporal lobe resection for drug-resistant epilepsy (DRE) are well established. For instance, left anterior temporal lobectomy (LATL) is associated with a greater risk for cognitive morbidity compared to right (RATL). However, the impact of neuromodulatory devices, specifically responsive neurostimulation (RNS), remains an area of active interest. There are currently no head-to-head comparisons of neuropsychological outcomes after surgical resection and neuromodulation. This study reports on a cohort of 21 DRE patients with the RNS System who received comprehensive pre- and post-implantation neuropsychological testing. We compared both cognitive and seizure outcomes in the RNS group to those of 307 DRE patients who underwent LATL (n = 138) or RATL (n = 169). RNS patients had higher seizure rates pre-intervention. While fewer in the RNS group achieved Class I Engel outcomes compared to the ATL cohorts, RNS patients also showed seizure frequency declines from pre- to post-intervention that were similar to those who underwent resective surgery. Moreover, the RNS and RATL groups were similar in their neuropsychological outcomes, showing no significant cognitive decline post-intervention. In contrast, the LATL group notably declined in object naming and verbal list learning. Direct comparisons like this study may be used to guide clinicians in shared decision making to tailor management plans for patients’ overall treatment goals.

show abstract

Section: Introductionmentioning

confidence: 99%