Deep brain stimulation for refractory epilepsy: A meta-analysis of stimulation parameters

Clin Neurol Neurosurg. 2025 Sep:256:108992. doi: 10.1016/j.clineuro.2025.108992. Epub 2025 Jun 11.

Abstract

Background: Epilepsy affects approximately 50 million people worldwide, with around 30 % not responding to antiepileptic drugs. Neuromodulation therapies, such as deep brain stimulation (DBS), are increasingly crucial for managing poorly controlled epilepsy.

Methods: This study conducted a meta-analysis following PRISMA guidelines, systematically searching PubMed, Scopus, and Web of Science databases for studies on DBS in refractory epilepsy patients. Out of an initial 568 papers screened by title and abstract, 49 studies met the inclusion criteria, involving a total of 682 patients.

Results: Various DBS interventions were analyzed, targeting regions such as the anterior nucleus of the thalamus, centromedian thalamic nucleus, and hypothalamus, with diverse stimulation parameters, including voltage, frequency, and stimulation type. The analysis revealed that these parameters significantly impacted treatment success, with moderate variability among studies.

Conclusions: This meta-analysis underscores the importance of tailored DBS parameters to improve outcomes in patients with drug-resistant epilepsy, highlighting DBS as a promising treatment approach.

Keywords: DBS; Deep Brain Stimulation; Drug-resistant epilepsy; Neuromodulation therapies; Refractory Epilepsy.

Publication types

  • Meta-Analysis

MeSH terms

  • Deep Brain Stimulation* / methods
  • Drug Resistant Epilepsy* / therapy
  • Humans
  • Treatment Outcome