Long-term efficacy of anterior nucleus of the thalamus deep brain stimulation in drug-resistant epilepsy: a 5-year multicenter study

作者：Tianqi Hu, Hutao Xie, Ming Shan, Lin Sang, Bowen Yang, Quan Zhang, Dongmei Gao, Yuanyuan Jiao, Qinglong Guo, Shujuan Li, Yuxin Wang, Xiaohui Du, Anchao Yang, Fangang Meng, Jianguo Zhang, Kai Zhang, Hua Zhang · 发表于：BMC Medicine · 年份：2025 · DOI：10.1186/s12916-025-04465-5 · 被引用次数：11 · 研究领域：Neurological disorders and treatments、Epilepsy research and treatment、Vagus Nerve Stimulation Research

BACKGROUND: Deep brain stimulation (DBS) of the anterior nucleus of the thalamus (ANT-DBS) has demonstrated potential in reducing seizure frequency (SF) in patients with drug-resistant epilepsy (DRE). This multicenter retrospective study aimed to comprehensively evaluate the long-term effects of ANT-DBS on seizure reduction and neuropsychological outcomes, as well as to identify prognostic factors associated with postoperative efficacy. METHODS: We retrospectively analyzed data from DRE patients who underwent ANT-DBS across three epilepsy centers between July 2019 and December 2022. SF, responder rate, neuropsychological outcomes, and quality of life (QoL) were assessed using seizure diaries and standardized rating scales at baseline and annual follow-up. Univariate and multivariate regression analyses were performed to identify predictors of postoperative SF reduction. RESULTS: A total of 40 patients were included, with a mean age at surgery of 28.6 ± 11.1 years. The average monthly SF decreased from 15 at baseline to 6.5 at the 5-year follow-up (a 56.7% reduction, p < 0.001), with a responder rate of 62.5%. Therapeutic effect was most pronounced within the first 24 months after implantation. The Liverpool Seizure Severity Scale (LSSS) scores improved from 26.7 ± 5.2 to 17.9 ± 8.6 (p < 0.001). Mood conditions (measured by the Hamilton Depression and Anxiety Rating Scales) improved from baseline to the final follow-up, while cognitive status remained stable. QoL also improved...