ArticleEpilepsia2020
Early detection rate changes from a brain-responsive neurostimulation system predict efficacy of newly added antiseizure drugs.
Article in Epilepsia, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 46 citations in OpenAlex.
- Monitoring Antiseizure Medication Change Using Ultra Long-Term Electroencephalogram: A Multicenter Study.Annals of neurology · 2026Article
- A guide to neuromodulation in drug-resistant epilepsy.Epileptic disorders : international epilepsy journal with videotape · 2026Review
- Markers of Antiseizure Treatment Efficacy in Children: A Review.Journal of clinical medicine · 2026Review
- The Palliative Nature of Pediatric Epilepsy Surgery and Our Procedures.Pediatric neurosurgery · 2026Review
- Epileptiform Activity and Seizure Risk Follow Long-Term Non-Linear Attractor Dynamics.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2025Article
- Long-Term Ambulatory Intracranial EEG.Stereotactic and functional neurosurgery · 2025Review
- Review
- Intracerebral electrographic activity following a single dose of diazepam nasal spray: A pilot study.Epilepsia open · 2024Article
- The present and future of seizure detection, prediction, and forecasting with machine learning, including the future impact on clinical trials.Frontiers in neurology · 2024Review
- Interictal epileptiform discharges contribute to word-finding difficulty in epilepsy through multiple cognitive mechanisms.Epilepsia · 2023Article
- Anterior nucleus of the thalamus deep brain stimulation vs temporal lobe responsive neurostimulation for temporal lobe epilepsy.Epilepsia · 2022Article
- Seizure control during the COVID-19 pandemic: Correlating Responsive Neurostimulation System data with patient reports.Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology · 2022Article
- Closed-Loop Brain Stimulation and Paradigm Shifts in Epilepsy Surgery.Neurologic clinics · 2022Review
- Responsive neurostimulation of the thalamus improves seizure control in idiopathic generalised epilepsy: initial case series.Journal of neurology, neurosurgery, and psychiatry · 2022Article
- Article
- Article
- Evidence for long memory in focal seizure duration.Epilepsia open · 2021Article
- Responsive Neurostimulation as a Novel Palliative Option in Epilepsy Surgery.Neurologia medico-chirurgica · 2021Review
- Under-sampling in epilepsy: Limitations of conventional EEG.Clinical neurophysiology practice · 2021Review
- Effects of anterior thalamic nuclei stimulation on hippocampal activity: Chronic recording in a patient with drug-resistant focal epilepsy.Epilepsy & behavior reports · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveBrain-responsive neurostimulation (RNS System, NeuroPace) is used to treat medically refractory focal epilepsy and also provides long-term ambulatory neurophysiologic data. We sought to determine whether these data could predict the clinical response to antiseizure drugs (ASDs).
methodsFirst, newly added medications were identified in RNS System patients followed at a single epilepsy center. Daily detection rates including "episode starts" (predominantly interictal activity) and "long episodes" (often electrographic seizures) were compared before and after ASD initiation. Efficacy was determined from documentation of clinical improvement and medication retention. Next, the analysis was repeated on an independent sample of patients from a multicenter long-term treatment trial, using an efficacy measure of ≥50% reduction in diary-recorded seizure frequency after 3 months.
resultsIn the single center cohort, long episodes, but not episode starts, had a significantly greater reduction in the first week for clinically efficacious compared to inefficacious medications. In this cohort, having no long episodes in the first week was highly predictive of ASD efficacy. In the multicenter cohort, both long episodes and episode starts had a significantly greater reduction for effective medications starting in the first 1-2 weeks. In this larger dataset, a ≥50% decrease in episode starts was 90% specific for efficacy with a positive predictive value (PPV) of 67%, and a ≥84% decrease in long episodes was 80% specific with a PPV of 48%. Conversely, a <25% decrease in long episodes (including any increase) or a <20% decrease in episode starts had a predictive value for inefficacy of >80%. SIGNIFICANCE: In RNS System patients with stable detection settings, when new ASDs are started, detection rates within the first 1-2 weeks may provide an early, objective indication of efficacy. These data could be used to identify responses to medication trials early to allow more rapid medication adjustments than conventionally possible.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.