Evidence map›Paper›PMID 41251192›Full record

ArticleEpilepsia open2026

sEEG-guided responsive neurostimulation to treat neocortical epilepsy: A multicenter retrospective study of the efficacy and safety of depth electrode-mediated neuromodulation.

Sina Sadeghzadeh, David A Purger, Priya Bhanot, Noriah Johnson, Daniel A N Barbosa, Yuhao Huang, Jay J Park, Ethan Schonfeld, Matthew A Abikenari, Bhav Jain and 21 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Epilepsia open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

31 authors.

Sina SadeghzadehDepartment of Neurosurgery, Stanford University School of Medicine, Stanford, California, USA.ORCID 0000-0003-3360-1016
David A PurgerDepartment of Neurosurgery, Stanford University, Stanford, California, USA.
Priya BhanotDepartment of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York City, New York, USA.
Noriah JohnsonDepartment of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA.
Daniel A N BarbosaDepartment of Neurology, Medical University of South Carolina, Charleston, South Carolina, USA.
Yuhao HuangDepartment of Neurosurgery, Stanford University, Stanford, California, USA.
Jay J ParkDepartment of Neurosurgery, Stanford University, Stanford, California, USA.
Ethan SchonfeldDepartment of Neurosurgery, Stanford University School of Medicine, Stanford, California, USA.
Matthew A AbikenariDepartment of Neurosurgery, Stanford University School of Medicine, Stanford, California, USA.
Bhav JainDepartment of Neurosurgery, Stanford University School of Medicine, Stanford, California, USA.
Joshua P AronsonDepartment of Neurosurgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
Cornelia DreesDepartment of Neurology, Mayo Clinic Arizona, Phoenix, Arizona, USA.ORCID 0000-0002-9977-983X
Tiffany L FisherDepartment of Neurology, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA.
Jason GerrardDepartment of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
Tyler E GrayDepartment of Neurology, Yale University School of Medicine, New Haven, Connecticut, USA.ORCID 0000-0003-1784-7817
Saadi GhatanDepartment of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York City, New York, USA.
Kevin HinesDepartment of Neurosurgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.ORCID 0000-0003-1700-174X
Barbara C JobstDepartment of Neurology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, USA.
Ioannis KarakisDepartment of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA.ORCID 0000-0001-5122-7211
Steven G OjemannDepartment of Neurosurgery, University of Colorado School of Medicine, Aurora, Colorado, USA.
Imran H QuraishiDepartment of Neurology, Yale University School of Medicine, New Haven, Connecticut, USA.ORCID 0000-0003-2859-7446
Ahmed M RaslanDepartment of Neurological Surgery, Oregon Health & Science University, Portland, Oregon, USA.ORCID 0000-0002-8421-7105
Michael D SatherDepartment of Neurosurgery, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA.
Christopher T SkidmoreDepartment of Neurology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Jon T WillieDepartment of Neurosurgery, Washington University School of Medicine, St. Louis, Missouri, USA.
Chengyuan WuDepartment of Neurosurgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.ORCID 0000-0002-3954-2929
Ji Yeoun YooDepartment of Neurology, Icahn School of Medicine at Mount Sinai, New York City, New York, USA.ORCID 0000-0001-7242-9779
Kevin D GraberDepartment of Neurology, Stanford University, Stanford, California, USA.
Casey H HalpernDepartment of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Vivek P BuchDepartment of Neurosurgery, Stanford University, Stanford, California, USA.
Jonathon J ParkerDepartment of Neurosurgery, Mayo Clinic Arizona, Phoenix, Arizona, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesPivotal trials have established the effectiveness of the Responsive Neurostimulation System (RNS® System) in treating focal epilepsy. In clinical trials, depth leads were primarily used to treat mesial temporal seizure onsets while cortical strip leads were used to treat neocortical seizure onsets. Here, we systematically analyze the safety and efficacy of stereoelectroencephalography (sEEG)-guided depth leads to provide responsive stimulation to neocortical gray matter.

methodsPatients were stratified as strong responders (>median cohort seizure reduction %), weak responders (>0% and ≤median cohort seizure reduction %), and anti-responders (≤0%) based on percent seizure reduction at 1 year post-implant (1-Y). Pre-operative T1-weighted magnetic resonance imaging and post-operative computed tomography images were merged, and the Euclidean distance between the sEEG epileptic focus (sEEG-EF) and the nearest RNS System depth lead contacts was calculated.

resultsA total of 87 depth leads were implanted in 55 patients across neocortical brain regions. The median reduction in clinical seizures improved from 66.7% at 1-Y to 77.5% at long-term follow-up (LTFU: 2.35 ± 0.95 years), with 10 patients (18.2%) achieving complete seizure freedom. Seven patients (12.7%) experienced six serious adverse events. At 1-Y, shorter Euclidean distance between the sEEG-EF and RNS System depth leads predicted improved seizure outcome in strong responders (β = -0.84, p = 0.008) but not in weak responders (β = 0.21, p = 0.9) or anti-responders (β = -20.34, p = 0.11). At LTFU, there was no significant relationship between Euclidean distance and seizure reduction in strong responders (β = 0.77, p = 0.18), weak responders (β = 2.05, p = 0.54), or anti-responders (β = 0.24, p = 0.99). Exploratory analyses at 1-Y showed nominal associations between older age (ρ = 0.32), longer epilepsy duration (ρ = 0.27), and non-mesial temporal sEEG-EFs and greater seizure reduction; however, none survived Bonferroni correction (adjusted α = 0.0027; all post-correction p > 0.0027), and no associations were observed at LTFU. SIGNIFICANCE: In this series, neocortical depth leads for RNS therapy had favorable safety and efficacy and proximity to the sEEG-EF drove initial outcomes for strong responders to RNS therapy. PLAIN LANGUAGE SUMMARY: In this multi-center study, patients with difficult-to-treat seizures received brain-responsive stimulation using a device called responsive neurostimulation (RNS), which delivers small electrical pulses to reduce seizures. We focused on patients treated with electrodes placed in the brain's outer regions (the neocortex) and guided by a mapping procedure called sEEG. On average, patients had their seizures cut by two-thirds after one year and by more than three-quarters with longer follow-up, with about one in five becoming seizure-free. The treatment was safe, and closer electrode placement to the seizure source helped explain early-but not long-term-improvements.

Indexed as

Deep Brain StimulationElectroencephalographyEpilepsies, PartialNeocortexAdolescentAdultChildDrug Resistant EpilepsyElectrodes, ImplantedFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedRetrospective StudiesStereotaxic Techniquesdepth electrodeneocortexnetwork remodelingresponsive neurostimulation (RNS)seizurestereoelectroencephalography (sEEG)

Identifiers

PMID41251192
PMCPMC12903807

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.