Evidence map›Paper›PMID 41618965›Full record

Observational studyEpilepsia open2026

Cognitive safety under epicranial cortex stimulation of the epileptic focus.

Kathrin Wagner, Iris Gorny, Julia Kustermann, Jessika Paula Losacker, Birgitta Metternich, Julia Berg, Bastian E A Sajonz, Volker Arnd Coenen, Elisabeth Kaufmann, Susanne Knake and 1 more

Abstract readMulticenter StudyObservational Study
In one paragraph

Observational study in Epilepsia open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

11 authors.

Kathrin WagnerDepartment of Neurosurgery, Epilepsy Center, Medical Center, University of Freiburg, Freiburg, Germany.ORCID https://orcid.org/0000-0003-2232-1684
Iris GornyDepartment of Neurology, Faculty of Medicine, Epilepsy Center Hessen, Philipps-University Marburg, Marburg, Germany.
Julia KustermannDepartment of Neurology, Epilepsy Center Muenchen, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany.
Jessika Paula LosackerDepartment of Neurosurgery, Epilepsy Center, Medical Center, University of Freiburg, Freiburg, Germany.
Birgitta MetternichDepartment of Neurosurgery, Epilepsy Center, Medical Center, University of Freiburg, Freiburg, Germany.ORCID https://orcid.org/0000-0001-8517-0081
Julia BergDepartment of Neurosurgery, Epilepsy Center, Medical Center, University of Freiburg, Freiburg, Germany.
Bastian E A SajonzDepartment of Stereotactic and Functional Neurosurgery, Medical Center, University of Freiburg, Freiburg, Germany.
Volker Arnd CoenenDepartment of Stereotactic and Functional Neurosurgery, Medical Center, University of Freiburg, Freiburg, Germany.
Elisabeth KaufmannDepartment of Neurology, Epilepsy Center Muenchen, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany.ORCID https://orcid.org/0000-0002-7582-2215
Susanne KnakeDepartment of Neurology, Faculty of Medicine, Epilepsy Center Hessen, Philipps-University Marburg, Marburg, Germany.
Andreas Schulze-BonhageDepartment of Neurosurgery, Epilepsy Center, Medical Center, University of Freiburg, Freiburg, Germany.ORCID https://orcid.org/0000-0003-2382-0506

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Epicranial focal cortex stimulation (FCS) is a new CE-certified treatment for pharmacoresistant focal epilepsy. In a multicenter observational trial, we report cognitive tolerability in 11 patients with pharmacoresistant epilepsy undergoing epicranial focal cortex stimulation (eFCS) over the predominant seizure focus (left temporal (N = 4), central (N = 2 right, N = 1 left), left frontal (N = 2), left temporoparietal (N = 1), and left frontoparietal (N = 1)). Extensive cognitive assessment focused on domains represented in the stimulated areas and was compared between baseline and first and last follow-up (after a median 35 months of stimulation). Based on the reliable change index, the majority of patients remained cognitively stable; 3/11 patients showed improvements in more than one cognitive parameter at both follow-up assessments. Isolated task parameters deteriorated exclusively at one time point; no patient revealed consistent worsening. Cognitive changes did not correspond to stimulation site or seizure outcome. Overall, the results from this case study provide preliminary evidence of stable cognitive functioning under focal cortical stimulation even if performed over eloquent brain regions. These findings are limited by the patient sample size and medication changes in part of the patients and need corroboration in larger patient cohorts. PLAIN LANGUAGE SUMMARY: We report on preliminary results of a new brain stimulation treatment for epilepsy that doesn't respond to medication. Over about 3 years, 11 patients showed stable cognitive performance, some even improved, and no patient had lasting declines. These results provide preliminary evidence that the treatment is generally safe for brain function. However, larger studies are needed to confirm these findings.

Indexed as

Cerebral CortexCognitionDrug Resistant EpilepsyElectric Stimulation TherapyEpilepsies, PartialAdultFemaleFollow-Up StudiesHumansMaleMiddle AgedNeuropsychological TestsTreatment OutcomeYoung Adulteloquent cortexexecutive functionmemoryneurostimulationnoninvasive

Identifiers

PMID41618965
PMCPMC13052126

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.