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Deep brain stimulation of the anterior nucleus of the thalamus in drug-resistant epilepsy in the MORE multicenter patient registry

2023Artigo científico Acesso aberto
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dc.contributor.authorPeltola, Jukka
dc.contributor.authorColon, Albert J.
dc.contributor.authorPimentel, José
dc.contributor.authorCoenen, Volker A.
dc.contributor.authorGil-Nagel, Antonio
dc.contributor.authorGonçalves Ferreira, António
dc.contributor.authorLehtimäki, Kai
dc.contributor.authorRyvlin, Philippe
dc.contributor.authorTaylor, Rod S.
dc.contributor.authorAckermans, Linda
dc.contributor.authorArdesch, Jacqueline
dc.contributor.authorBentes, Carla
dc.contributor.authorBosak, Magdalena
dc.contributor.authorBurneo, Jorge G.
dc.contributor.authorChamadoira, Clara
dc.contributor.authorElger, Christian E.
dc.contributor.authorErőss, Loránd
dc.contributor.authorFabo, Dániel
dc.contributor.authorFaulkner, Howard
dc.contributor.authorGawlowicz, Jacek
dc.contributor.authorGharabaghi, Alireza
dc.contributor.authorIacoangeli, Maurizio
dc.contributor.authorJanszky, Jozsef
dc.contributor.authorJärvenpää, Soila
dc.contributor.authorKaufmann, Elisabeth
dc.contributor.authorKho, Kuan H.
dc.contributor.authorKumlien, Eva
dc.contributor.authorLaufs, Helmut
dc.contributor.authorLettieri, Christian
dc.contributor.authorLinhares, Paulo
dc.contributor.authorNoachtar, Soheyl
dc.contributor.authorParrent, Andrew
dc.contributor.authorPataraia, Ekaterina
dc.contributor.authorPatel, Nikunj K.
dc.contributor.authorPeralta, Ana
dc.contributor.authorRácz, Attila
dc.contributor.authorRainha Campos, Alexandre
dc.contributor.authorRego, Ricardo
dc.contributor.authorRicciuti, Riccardo A.
dc.contributor.authorRona, Sabine
dc.contributor.authorRouhl, Rob P.W.
dc.contributor.authorSchulze-Bonhage, Andreas
dc.contributor.authorSchuurman, Rick
dc.contributor.authorSprengers, Mathieu
dc.contributor.authorSufianov, Albert
dc.contributor.authorTemel, Yasin
dc.contributor.authorTheys, Tom
dc.contributor.authorVan Paesschen, Wim
dc.contributor.authorVan Roost, Dirk
dc.contributor.authorVaz, Rui
dc.contributor.authorVonck, Kristl
dc.contributor.authorWagner, Louis
dc.contributor.authorZwemmer, Jack
dc.contributor.authorAbouihia, Abdallah
dc.contributor.authorBrionne, Thomas C.
dc.contributor.authorGielen, Frans
dc.contributor.authorBoon, Paul A.J.M.
dc.date.accessioned2023-05-03T11:42:09Z
dc.date.available2023-05-03T11:42:09Z
dc.date.issued2023
dc.descriptionCopyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology. This is an open access article distributed under the terms of the Creative Commons Attribution License 4.0 (CC BY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.pt_PT
dc.description.abstractBackground and objectives: The efficacy of deep brain stimulation of the anterior nucleus of the thalamus (ANT DBS) in patients with drug-resistant epilepsy (DRE) was demonstrated in the double-blind Stimulation of the Anterior Nucleus of the Thalamus for Epilepsy randomized controlled trial. The Medtronic Registry for Epilepsy (MORE) aims to understand the safety and longer-term effectiveness of ANT DBS therapy in routine clinical practice. Methods: MORE is an observational registry collecting prospective and retrospective clinical data. Participants were at least 18 years old, with focal DRE recruited across 25 centers from 13 countries. They were followed for at least 2 years in terms of seizure frequency (SF), responder rate (RR), health-related quality of life (Quality of Life in Epilepsy Inventory 31), depression, and safety outcomes. Results: Of the 191 patients recruited, 170 (mean [SD] age of 35.6 [10.7] years, 43% female) were implanted with DBS therapy and met all eligibility criteria. At baseline, 38% of patients reported cognitive impairment. The median monthly SF decreased by 33.1% from 15.8 at baseline to 8.8 at 2 years (p < 0.0001) with 32.3% RR. In the subgroup of 47 patients who completed 5 years of follow-up, the median monthly SF decreased by 55.1% from 16 at baseline to 7.9 at 5 years (p < 0.0001) with 53.2% RR. High-volume centers (>10 implantations) had 42.8% reduction in median monthly SF by 2 years in comparison with 25.8% in low-volume center. In patients with cognitive impairment, the reduction in median monthly SF was 26.0% by 2 years compared with 36.1% in patients without cognitive impairment. The most frequently reported adverse events were changes (e.g., increased frequency/severity) in seizure (16%), memory impairment (patient-reported complaint, 15%), depressive mood (patient-reported complaint, 13%), and epilepsy (12%). One definite sudden unexpected death in epilepsy case was reported. Discussion: The MORE registry supports the effectiveness and safety of ANT DBS therapy in a real-world setting in the 2 years following implantation. Classification of evidence: This study provides Class IV evidence that ANT DBS reduces the frequency of seizures in patients with drug-resistant focal epilepsy.pt_PT
dc.description.sponsorshipThe MORE registry was sponsored and funded by Medtronic, plc.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationNeurology. 2023 May 2;100(18):e1852-e1865pt_PT
dc.identifier.doi10.1212/WNL.0000000000206887pt_PT
dc.identifier.eissn1526-632X
dc.identifier.issn0028-3878
dc.identifier.urihttp://hdl.handle.net/10451/57325
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherAmerican Academy of Neurologypt_PT
dc.relation.publisherversionhttps://n.neurology.org/pt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.titleDeep brain stimulation of the anterior nucleus of the thalamus in drug-resistant epilepsy in the MORE multicenter patient registrypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPagee1865pt_PT
oaire.citation.issue18pt_PT
oaire.citation.startPagee1852pt_PT
oaire.citation.titleNeurologypt_PT
oaire.citation.volume100pt_PT
person.familyNamePimentel
person.familyNameFerreira
person.familyNameBentes
person.familyNamePeralta
person.familyNameRainha Campos
person.givenNameJosé
person.givenNameAntónio José de Carvalho Gonçalves
person.givenNameCarla
person.givenNameAna Rita
person.givenNameAlexandre
person.identifier.ciencia-id7D1C-D5DD-C579
person.identifier.ciencia-id1D1D-D037-54D8
person.identifier.ciencia-id2910-471A-8664
person.identifier.orcid0000-0002-6101-6650
person.identifier.orcid0000-0002-1933-0304
person.identifier.orcid0000-0003-2399-7678
person.identifier.orcid0000-0001-9449-431X
person.identifier.orcid0000-0003-4781-4717
person.identifier.scopus-author-id7006096045
person.identifier.scopus-author-id6603378059
person.identifier.scopus-author-id6603395191
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
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