SynthesisChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2025
Neurostimulation in children with drug-resistant epilepsy: strategies in subcortical targeting and systematic review of the evidence.
Synthesis in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe aim of this study is to delineate technical considerations for subcortical electrode targeting in children with DRE and to present a target selection decision-support tool for pediatric neurosurgeons for DBS and RNS.
methodsA systematic review of studies through age ≤ 19 years reporting DBS or RNS implantation for DRE was performed. Articles were screened for details on trajectory planning, imaging parameters, intraoperative workflows, and direct versus indirect targeting strategies. Primary outcomes were seizure-frequency reduction and responder rate; secondary outcomes included perioperative adverse events and identification of pediatric-specific factors influencing surgical planning.
resultsSeventeen studies (10 DBS, 7 RNS; total n = 333 children) met inclusion criteria. Median age was 16.0 ± 6.35 years; median epilepsy duration was 12.15 ± 7.98 years; 41.4% carried a diagnosis of Lennox-Gastaut syndrome. Frame-based stereotaxy predominated (12/17 studies; 168/238 procedures, 70.6%), with robotic assistance in 20.6% (3/17; 49/238). Thirteen studies specified targeting method-nine direct, four indirect. Targets were the anterior nucleus of the thalamus (ANT; n = 25, 10.4%), centromedian nucleus (CMN; n = 200, 83.3%), pulvinar nucleus (PVN; n = 1, 0.4%), and hippocampus (HC; n = 14, 5.8%). Pooled weighted median seizure reduction was 54.7 ± 9.1% over a median follow-up of 20.4 ± 17.6 months; pooled weighted median responder rate was 63.0 ± 17.3% over the same interval. Subgroup analyses showed target-dependent outcome variability. DBS versus RNS subgroup comparison showed no difference in seizure reduction but did show a difference in responder rates. Complication rate was 13.3%.
conclusionStereotactic subcortical targeting in pediatric DRE achieves meaningful seizure reduction and responder rates, with acceptable safety. Direct and indirect targeting strategies must account for unique pediatric considerations. A practical tool for trajectory planning, imaging selection, and targeting methodology for DBS and RNS in children is provided.
Indexed as
Identifiers
41364200What OpenQuestion holds
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.