Posters
Presenting Author Academic/Professional Position
Medical Student
Academic Level (Author 1)
Medical Student
Academic Level (Author 2)
Medical Student
Academic Level (Author 3)
Medical Student
Academic Level (Author 4)
Medical Student
Academic Level (Author 5)
Medical Student
Presentation Type
Poster
Discipline Track
Clinical Science
Abstract Type
Research/Clinical
Abstract
Introduction: Although there are over twenty antiseizure drugs currently available, around one third of patients with epilepsy do not benefit from these medications. Patients with drug-resistant epilepsy (DRE) experience higher rates of hospitalization, notable decline in cognitive and physical abilities, diminished quality of life, and sudden unexpected death. Neuromodulation techniques such as Vagus Nerve Stimulation (VNS), Responsive Neurostimulation (RNS), and Deep Brain Stimulation (DBS) are quickly emerging as alternative and adjunct therapies for epilepsy, offering patients and physicians a new avenue of treatment. Despite their promise, a notable gap exists in comprehensive, comparative data assessing the efficacy and suitability of these techniques across diverse patient demographics and epilepsy types. Here, we evaluated the efficacy of VNS, RNS, and DBS in reducing seizure frequency and the impact on quality of life of patients with drug resistant epilepsy.
Methods: We developed a comprehensive search strategy to identify relevant studies in PubMed, Medline, and PubMed Central, utilizing Medical Subject Headings (MeSH) terms and keywords. The search yielded 123 potential studies for further review. We screened for relevance, participant age group, and English language. After comprehensive screening, 16 studies were deemed suitable for this study. A total of 438 patients diagnosed with DRE were included. They were assigned to DBS, VNS, and RNS. This research adhered to the PRISMA recommendations.
Results: At 24 months, DBS showed a decrease in total seizure frequency of 49.16% (±SD 41.65), and a decrease of focal to bilateral tonic–clonic seizures (FBTCS) of 67.93% (±SD 33.33). In patients with focal seizures and mesial temporal sclerosis, DBS resulted in a median reduction of 75.5% in seizure frequency, with 77% reduction in focal-to-bilateral tonic–clonic seizures (p = 0.008). RNS had 58.1% reduction in seizure frequency, while VNS had 46.3%. Responder rates were higher for RNS (66.7%) compared to VNS (45.5%) at 1 year. Additionally, patients receiving VNS in combination with SV2A modulators or slow sodium channel inhibitors had higher response rate and seizure freedom.
Conclusion: The emergence of neuromodalities as a treatment option for patients with drug-resistant epilepsy has provided hope for better prognosis and improved quality of life. Our findings revealed neuromodulation treatment reduced seizure frequency, while showing fewer executive dysfunction symptoms and improvements in sleep and cognition. Although neuromodalities have significantly reduced seizure frequency and increased responder rates, the magnitude of the effect varied considerably between treatment modalities with DBS showing larger effect sizes. Furthermore, several challenges hinder the widespread adoption of neuromodulation, such as variable patient responses and device-related complications, and the need for ongoing adjustments remain significant. Future research should thus focus on reducing the cost of implanting and maintenance of such modalities, making neuromodulation and accessible treatment modalities for the near future.
Recommended Citation
Garcia Valdez, Kevin; Murambadoro, Anesu Karen; Szobody, Megan W.; Martin, Blake C.; Punch, Kory D.; Sayers, Tori; Patel, Tirath; Mourao, Nina; Gullapalli, Sriya; Anand, Nikhilesh; and Gadad, Bharathi S., "Neuromodulation Techniques for Drug-Resistant Epilepsy: Effects on Seizures and Quality of Life" (2025). Research Symposium. 90.
https://scholarworks.utrgv.edu/somrs/2025/posters/90
Neuromodulation Techniques for Drug-Resistant Epilepsy: Effects on Seizures and Quality of Life
Introduction: Although there are over twenty antiseizure drugs currently available, around one third of patients with epilepsy do not benefit from these medications. Patients with drug-resistant epilepsy (DRE) experience higher rates of hospitalization, notable decline in cognitive and physical abilities, diminished quality of life, and sudden unexpected death. Neuromodulation techniques such as Vagus Nerve Stimulation (VNS), Responsive Neurostimulation (RNS), and Deep Brain Stimulation (DBS) are quickly emerging as alternative and adjunct therapies for epilepsy, offering patients and physicians a new avenue of treatment. Despite their promise, a notable gap exists in comprehensive, comparative data assessing the efficacy and suitability of these techniques across diverse patient demographics and epilepsy types. Here, we evaluated the efficacy of VNS, RNS, and DBS in reducing seizure frequency and the impact on quality of life of patients with drug resistant epilepsy.
Methods: We developed a comprehensive search strategy to identify relevant studies in PubMed, Medline, and PubMed Central, utilizing Medical Subject Headings (MeSH) terms and keywords. The search yielded 123 potential studies for further review. We screened for relevance, participant age group, and English language. After comprehensive screening, 16 studies were deemed suitable for this study. A total of 438 patients diagnosed with DRE were included. They were assigned to DBS, VNS, and RNS. This research adhered to the PRISMA recommendations.
Results: At 24 months, DBS showed a decrease in total seizure frequency of 49.16% (±SD 41.65), and a decrease of focal to bilateral tonic–clonic seizures (FBTCS) of 67.93% (±SD 33.33). In patients with focal seizures and mesial temporal sclerosis, DBS resulted in a median reduction of 75.5% in seizure frequency, with 77% reduction in focal-to-bilateral tonic–clonic seizures (p = 0.008). RNS had 58.1% reduction in seizure frequency, while VNS had 46.3%. Responder rates were higher for RNS (66.7%) compared to VNS (45.5%) at 1 year. Additionally, patients receiving VNS in combination with SV2A modulators or slow sodium channel inhibitors had higher response rate and seizure freedom.
Conclusion: The emergence of neuromodalities as a treatment option for patients with drug-resistant epilepsy has provided hope for better prognosis and improved quality of life. Our findings revealed neuromodulation treatment reduced seizure frequency, while showing fewer executive dysfunction symptoms and improvements in sleep and cognition. Although neuromodalities have significantly reduced seizure frequency and increased responder rates, the magnitude of the effect varied considerably between treatment modalities with DBS showing larger effect sizes. Furthermore, several challenges hinder the widespread adoption of neuromodulation, such as variable patient responses and device-related complications, and the need for ongoing adjustments remain significant. Future research should thus focus on reducing the cost of implanting and maintenance of such modalities, making neuromodulation and accessible treatment modalities for the near future.
