Effect of deep brain stimulation on the severity of seizures and the quality of life in patients with multifocal drug-resistant epilepsy in Iran: A pilot review of local experience

深部脑刺激对伊朗多灶性药物难治性癫痫患者癫痫发作严重程度和生活质量的影响:一项基于当地经验的初步回顾

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Abstract

This study investigates the impact of the anterior nucleus of the thalamus deep brain stimulation (ANT-DBS) on patients with drug-resistant epilepsy (DRE) in Iran, specifically focusing on its effects on seizure metrics, severity and its influence on quality of life over time. A cohort of eight patients with DRE in Iran who underwent ANT-DBS was evaluated. Pre-operative assessments included comprehensive documentation of seizure frequency, duration, severity scores, and the Quality of Life in Epilepsy Inventory (QOLIE-13). Each patient also underwent high-resolution imaging using a 1.5 Tesla MRI, with targeted electrode placement in the anterior thalamic area. Post-operative evaluations measured changes in seizure frequency, severity scores, duration, and quality of life indicators. All subjects presented with DRE, and the mean age of participants was 24.62 years. Post-operative data revealed significantly reduced seizure frequency, duration, and severity scores. Notably, this reduction was more pronounced at the 6-month follow-up than the 3-month assessment, indicating a progressive therapeutic effect. All patients demonstrated a response to ANT-DBS, with two individuals achieving seizure freedom. Additionally, there was a marked improvement in quality of life, particularly in the domains of energy/fatigue and social functioning. ANT-DBS has been established as a promising and safe therapeutic intervention for patients with DRE. In a cohort of DRE patients in Iran, the treatment demonstrated comparable efficacy in decreasing seizure frequency and severity and enhancing self-reported quality of life, consistent with findings reported in the existing literature. The therapeutic benefits of ANT-DBS appear to augment over time.

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