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Add-On Deep Brain Stimulation versus Continued Vagus Nerve Stimulation for Childhood Epilepsy (ADVANCE): A Partially Randomized Patient Preference Trial.

Hrishikesh SureshKarim MithaniNebras WarsiAyako OchiHiroshi OtsuboJames M DrakeJames T RutkaElizabeth KerrMary Lou SmithSara BreitbartIvanna YauLyndsey McRaeVann ChauShelly WeissPuneet JainElizabeth DonnerAlfonso FasanoCarolina GorodetskyGeorge M Ibrahim
Published in: Annals of neurology (2024)
Outcomes following vagus nerve stimulation (VNS) improve over years after implantation in children with drug-resistant epilepsy. The added value of deep brain stimulation (DBS) instead of continued VNS optimization is unknown. In a prospective, non-blinded, randomized patient preference trial of 18 children (aged 8-17 years) who did not respond to VNS after at least 1 year, add-on DBS resulted in greater seizure reduction compared with an additional year of VNS optimization (51.9% vs. 12.3%, p = 0.047). Add-on DBS also resulted in less bothersome seizures (p = 0.03), but no change in quality of life. DBS may be considered earlier for childhood epilepsy after non-response to VNS. ANN NEUROL 2024.
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