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Seizure outcome with responsive neurostimulation (RNS) comparing strip versus depth leads
Epilepsy & Behavior ( IF 2.3 ) Pub Date : 2020-11-01 , DOI: 10.1016/j.yebeh.2020.107402
Cornelia Drees 1 , Danielle McDermott 1 , Stefan Sillau 1 , Aviva Abosch 2 , Steven Ojemann 3 , Saul Schwarz 4 , Mesha-Gay Brown 1
Affiliation  

OBJECTIVE This study aimed to compare seizure outcomes and complication rates in patients treated with only responsive neurostimulation (RNS) strip leads with those treated with only RNS depth leads. METHODS A retrospective cohort study was performed using the institutional epilepsy surgery database. Included was any patient implanted with the RNS system between August 2015 and May 2018 with either two depth (2D) or two strip (2S) leads connected to the device and at least 6 months follow-up. Excluded were those with a combination of active depth and strip leads. Data extracted from the charts comprised demographic information, duration of epilepsy, presence of a magnetic resonance imaging (MRI) lesion, prior resective surgery, clinically disabling seizures at baseline and follow-up, prior invasive monitoring, location (mesial temporal or neocortical) and number of seizure foci, unilateral or bilateral RNS lead placement, and postoperative complications. RESULTS Of 48 screened patients, 34 met study inclusion criteria. Of these, 15 were treated with 2D leads and 19 with 2S leads. Groups 2D and 2S were comparable with respect to age at onset, duration of epilepsy, baseline seizure frequency, and exposure time to RNS. After adjustment for patient age and duration of epilepsy, seizure frequency in 2S patients was noted to be decreased by 83% (p = 0.046), while it was reduced by 51% (p = 0.080) in 2D patients. The complication rate was not significantly different between the two groups. CONCLUSION In our small retrospective population, patients with RNS strip leads experienced a significantly greater seizure reduction than patients with RNS depth leads, without a difference in complication rate.

中文翻译:

比较带状导联与深度导联的反应性神经刺激 (RNS) 的癫痫结果

目的 本研究旨在比较仅使用响应性神经刺激 (RNS) 条形导线治疗的患者与仅使用 RNS 深度导线治疗的患者的癫痫发作结果和并发症发生率。方法 使用机构癫痫手术数据库进行回顾性队列研究。包括在 2015 年 8 月至 2018 年 5 月期间植入 RNS 系统且两个深度 (2D) 或两个条形 (2S) 引线连接到设备并至少随访 6 个月的任何患者。排除了那些具有有效深度和带状引线的组合。从图表中提取的数据包括人口统计信息、癫痫持续时间、磁共振成像 (MRI) 病变的存在、先前的切除手术、基线和随访时的临床禁用癫痫发作、先前的侵入性监测、位置(颞叶内侧或新皮质)和癫痫病灶数量、单侧或双侧 RNS 导线放置以及术后并发症。结果 在 48 名接受筛查的患者中,34 名符合研究纳入标准。其中,15 例采用 2D 导联,19 例采用 2S 导联。2D 和 2S 组在发病年龄、癫痫持续时间、基线癫痫发作频率和 RNS 暴露时间方面具有可比性。在调整患者年龄和癫痫持续时间后,2S 患者的癫痫发作频率降低了 83% (p = 0.046),而 2D 患者的癫痫发作频率降低了 51% (p = 0.080)。两组并发症发生率无显着差异。结论 在我们的小型回顾性人群中,与 RNS 深度导联的患者相比,使用 RNS 条形导联的患者的癫痫发作减少明显更多,
更新日期:2020-11-01
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