March 10, 2015; 84 (10) Article
Long-term efficacy and safety of thalamic stimulation for drug-resistant partial epilepsy
Vicenta Salanova, Thomas Witt, Robert Worth, Thomas R. Henry, Robert E. Gross, Jules M. Nazzaro, Douglas Labar, Michael R. Sperling, Ashwini Sharan, Evan Sandok, Adrian Handforth, John M. Stern, Steve Chung, Jaimie M. Henderson, Jacqueline French, Gordon Baltuch, William E. Rosenfeld, Paul Garcia, Nicholas M. Barbaro, Nathan B. Fountain, W. Jeffrey Elias, Robert R. Goodman, John R. Pollard, Alexander I. Tröster, Christopher P. Irwin, Kristin Lambrecht, Nina Graves, Robert Fisher, For the SANTE Study Group
First published February 6, 2015, DOI: https://doi.org/10.1212/WNL.0000000000001334
Vicenta Salanova
From Indiana University (V.S., T.W., R.W., N.M.B.), Indianapolis; University of Minnesota (T.R.H.), Minneapolis; Emory University (R.E.G.), Atlanta, GA; University of Kansas (J.M.N.), Kansas City; Weill Cornell (D.L.), New York, NY; Thomas Jefferson University (M.R.S., A.S.), Philadelphia, PA; Marshfield Clinic (E.S.), WI; Veterans Affairs Greater Los Angeles Healthcare System (A.H.); Geffen School of Medicine at UCLA (J.M.S.), Los Angeles, CA; Barrow Neurological Institute (S.C., A.I.T.), Phoenix, AZ; Stanford University (J.M.H., R.F.), CA; NYU Comprehensive Epilepsy Center (J.F.), New York, NY; University of Pennsylvania (G.B., J.R.P.), PA; St. Luke's (W.E.R.), St. Louis, MO; University of California San Francisco (P.G.); University of Virginia School of Medicine (N.B.F., W.J.E.), Charlottesville; Mount Sinai (R.R.G.), New York, NY; and Medtronic, Inc. (C.P.I., K.L., N.G.), Minneapolis, MN.
Thomas Witt
From Indiana University (V.S., T.W., R.W., N.M.B.), Indianapolis; University of Minnesota (T.R.H.), Minneapolis; Emory University (R.E.G.), Atlanta, GA; University of Kansas (J.M.N.), Kansas City; Weill Cornell (D.L.), New York, NY; Thomas Jefferson University (M.R.S., A.S.), Philadelphia, PA; Marshfield Clinic (E.S.), WI; Veterans Affairs Greater Los Angeles Healthcare System (A.H.); Geffen School of Medicine at UCLA (J.M.S.), Los Angeles, CA; Barrow Neurological Institute (S.C., A.I.T.), Phoenix, AZ; Stanford University (J.M.H., R.F.), CA; NYU Comprehensive Epilepsy Center (J.F.), New York, NY; University of Pennsylvania (G.B., J.R.P.), PA; St. Luke's (W.E.R.), St. Louis, MO; University of California San Francisco (P.G.); University of Virginia School of Medicine (N.B.F., W.J.E.), Charlottesville; Mount Sinai (R.R.G.), New York, NY; and Medtronic, Inc. (C.P.I., K.L., N.G.), Minneapolis, MN.
Robert Worth
From Indiana University (V.S., T.W., R.W., N.M.B.), Indianapolis; University of Minnesota (T.R.H.), Minneapolis; Emory University (R.E.G.), Atlanta, GA; University of Kansas (J.M.N.), Kansas City; Weill Cornell (D.L.), New York, NY; Thomas Jefferson University (M.R.S., A.S.), Philadelphia, PA; Marshfield Clinic (E.S.), WI; Veterans Affairs Greater Los Angeles Healthcare System (A.H.); Geffen School of Medicine at UCLA (J.M.S.), Los Angeles, CA; Barrow Neurological Institute (S.C., A.I.T.), Phoenix, AZ; Stanford University (J.M.H., R.F.), CA; NYU Comprehensive Epilepsy Center (J.F.), New York, NY; University of Pennsylvania (G.B., J.R.P.), PA; St. Luke's (W.E.R.), St. Louis, MO; University of California San Francisco (P.G.); University of Virginia School of Medicine (N.B.F., W.J.E.), Charlottesville; Mount Sinai (R.R.G.), New York, NY; and Medtronic, Inc. (C.P.I., K.L., N.G.), Minneapolis, MN.
Thomas R. Henry
From Indiana University (V.S., T.W., R.W., N.M.B.), Indianapolis; University of Minnesota (T.R.H.), Minneapolis; Emory University (R.E.G.), Atlanta, GA; University of Kansas (J.M.N.), Kansas City; Weill Cornell (D.L.), New York, NY; Thomas Jefferson University (M.R.S., A.S.), Philadelphia, PA; Marshfield Clinic (E.S.), WI; Veterans Affairs Greater Los Angeles Healthcare System (A.H.); Geffen School of Medicine at UCLA (J.M.S.), Los Angeles, CA; Barrow Neurological Institute (S.C., A.I.T.), Phoenix, AZ; Stanford University (J.M.H., R.F.), CA; NYU Comprehensive Epilepsy Center (J.F.), New York, NY; University of Pennsylvania (G.B., J.R.P.), PA; St. Luke's (W.E.R.), St. Louis, MO; University of California San Francisco (P.G.); University of Virginia School of Medicine (N.B.F., W.J.E.), Charlottesville; Mount Sinai (R.R.G.), New York, NY; and Medtronic, Inc. (C.P.I., K.L., N.G.), Minneapolis, MN.
Robert E. Gross
From Indiana University (V.S., T.W., R.W., N.M.B.), Indianapolis; University of Minnesota (T.R.H.), Minneapolis; Emory University (R.E.G.), Atlanta, GA; University of Kansas (J.M.N.), Kansas City; Weill Cornell (D.L.), New York, NY; Thomas Jefferson University (M.R.S., A.S.), Philadelphia, PA; Marshfield Clinic (E.S.), WI; Veterans Affairs Greater Los Angeles Healthcare System (A.H.); Geffen School of Medicine at UCLA (J.M.S.), Los Angeles, CA; Barrow Neurological Institute (S.C., A.I.T.), Phoenix, AZ; Stanford University (J.M.H., R.F.), CA; NYU Comprehensive Epilepsy Center (J.F.), New York, NY; University of Pennsylvania (G.B., J.R.P.), PA; St. Luke's (W.E.R.), St. Louis, MO; University of California San Francisco (P.G.); University of Virginia School of Medicine (N.B.F., W.J.E.), Charlottesville; Mount Sinai (R.R.G.), New York, NY; and Medtronic, Inc. (C.P.I., K.L., N.G.), Minneapolis, MN.
Jules M. Nazzaro
From Indiana University (V.S., T.W., R.W., N.M.B.), Indianapolis; University of Minnesota (T.R.H.), Minneapolis; Emory University (R.E.G.), Atlanta, GA; University of Kansas (J.M.N.), Kansas City; Weill Cornell (D.L.), New York, NY; Thomas Jefferson University (M.R.S., A.S.), Philadelphia, PA; Marshfield Clinic (E.S.), WI; Veterans Affairs Greater Los Angeles Healthcare System (A.H.); Geffen School of Medicine at UCLA (J.M.S.), Los Angeles, CA; Barrow Neurological Institute (S.C., A.I.T.), Phoenix, AZ; Stanford University (J.M.H., R.F.), CA; NYU Comprehensive Epilepsy Center (J.F.), New York, NY; University of Pennsylvania (G.B., J.R.P.), PA; St. Luke's (W.E.R.), St. Louis, MO; University of California San Francisco (P.G.); University of Virginia School of Medicine (N.B.F., W.J.E.), Charlottesville; Mount Sinai (R.R.G.), New York, NY; and Medtronic, Inc. (C.P.I., K.L., N.G.), Minneapolis, MN.
Douglas Labar
From Indiana University (V.S., T.W., R.W., N.M.B.), Indianapolis; University of Minnesota (T.R.H.), Minneapolis; Emory University (R.E.G.), Atlanta, GA; University of Kansas (J.M.N.), Kansas City; Weill Cornell (D.L.), New York, NY; Thomas Jefferson University (M.R.S., A.S.), Philadelphia, PA; Marshfield Clinic (E.S.), WI; Veterans Affairs Greater Los Angeles Healthcare System (A.H.); Geffen School of Medicine at UCLA (J.M.S.), Los Angeles, CA; Barrow Neurological Institute (S.C., A.I.T.), Phoenix, AZ; Stanford University (J.M.H., R.F.), CA; NYU Comprehensive Epilepsy Center (J.F.), New York, NY; University of Pennsylvania (G.B., J.R.P.), PA; St. Luke's (W.E.R.), St. Louis, MO; University of California San Francisco (P.G.); University of Virginia School of Medicine (N.B.F., W.J.E.), Charlottesville; Mount Sinai (R.R.G.), New York, NY; and Medtronic, Inc. (C.P.I., K.L., N.G.), Minneapolis, MN.
Michael R. Sperling
From Indiana University (V.S., T.W., R.W., N.M.B.), Indianapolis; University of Minnesota (T.R.H.), Minneapolis; Emory University (R.E.G.), Atlanta, GA; University of Kansas (J.M.N.), Kansas City; Weill Cornell (D.L.), New York, NY; Thomas Jefferson University (M.R.S., A.S.), Philadelphia, PA; Marshfield Clinic (E.S.), WI; Veterans Affairs Greater Los Angeles Healthcare System (A.H.); Geffen School of Medicine at UCLA (J.M.S.), Los Angeles, CA; Barrow Neurological Institute (S.C., A.I.T.), Phoenix, AZ; Stanford University (J.M.H., R.F.), CA; NYU Comprehensive Epilepsy Center (J.F.), New York, NY; University of Pennsylvania (G.B., J.R.P.), PA; St. Luke's (W.E.R.), St. Louis, MO; University of California San Francisco (P.G.); University of Virginia School of Medicine (N.B.F., W.J.E.), Charlottesville; Mount Sinai (R.R.G.), New York, NY; and Medtronic, Inc. (C.P.I., K.L., N.G.), Minneapolis, MN.
Ashwini Sharan
From Indiana University (V.S., T.W., R.W., N.M.B.), Indianapolis; University of Minnesota (T.R.H.), Minneapolis; Emory University (R.E.G.), Atlanta, GA; University of Kansas (J.M.N.), Kansas City; Weill Cornell (D.L.), New York, NY; Thomas Jefferson University (M.R.S., A.S.), Philadelphia, PA; Marshfield Clinic (E.S.), WI; Veterans Affairs Greater Los Angeles Healthcare System (A.H.); Geffen School of Medicine at UCLA (J.M.S.), Los Angeles, CA; Barrow Neurological Institute (S.C., A.I.T.), Phoenix, AZ; Stanford University (J.M.H., R.F.), CA; NYU Comprehensive Epilepsy Center (J.F.), New York, NY; University of Pennsylvania (G.B., J.R.P.), PA; St. Luke's (W.E.R.), St. Louis, MO; University of California San Francisco (P.G.); University of Virginia School of Medicine (N.B.F., W.J.E.), Charlottesville; Mount Sinai (R.R.G.), New York, NY; and Medtronic, Inc. (C.P.I., K.L., N.G.), Minneapolis, MN.
Evan Sandok
From Indiana University (V.S., T.W., R.W., N.M.B.), Indianapolis; University of Minnesota (T.R.H.), Minneapolis; Emory University (R.E.G.), Atlanta, GA; University of Kansas (J.M.N.), Kansas City; Weill Cornell (D.L.), New York, NY; Thomas Jefferson University (M.R.S., A.S.), Philadelphia, PA; Marshfield Clinic (E.S.), WI; Veterans Affairs Greater Los Angeles Healthcare System (A.H.); Geffen School of Medicine at UCLA (J.M.S.), Los Angeles, CA; Barrow Neurological Institute (S.C., A.I.T.), Phoenix, AZ; Stanford University (J.M.H., R.F.), CA; NYU Comprehensive Epilepsy Center (J.F.), New York, NY; University of Pennsylvania (G.B., J.R.P.), PA; St. Luke's (W.E.R.), St. Louis, MO; University of California San Francisco (P.G.); University of Virginia School of Medicine (N.B.F., W.J.E.), Charlottesville; Mount Sinai (R.R.G.), New York, NY; and Medtronic, Inc. (C.P.I., K.L., N.G.), Minneapolis, MN.
Adrian Handforth
From Indiana University (V.S., T.W., R.W., N.M.B.), Indianapolis; University of Minnesota (T.R.H.), Minneapolis; Emory University (R.E.G.), Atlanta, GA; University of Kansas (J.M.N.), Kansas City; Weill Cornell (D.L.), New York, NY; Thomas Jefferson University (M.R.S., A.S.), Philadelphia, PA; Marshfield Clinic (E.S.), WI; Veterans Affairs Greater Los Angeles Healthcare System (A.H.); Geffen School of Medicine at UCLA (J.M.S.), Los Angeles, CA; Barrow Neurological Institute (S.C., A.I.T.), Phoenix, AZ; Stanford University (J.M.H., R.F.), CA; NYU Comprehensive Epilepsy Center (J.F.), New York, NY; University of Pennsylvania (G.B., J.R.P.), PA; St. Luke's (W.E.R.), St. Louis, MO; University of California San Francisco (P.G.); University of Virginia School of Medicine (N.B.F., W.J.E.), Charlottesville; Mount Sinai (R.R.G.), New York, NY; and Medtronic, Inc. (C.P.I., K.L., N.G.), Minneapolis, MN.
John M. Stern
From Indiana University (V.S., T.W., R.W., N.M.B.), Indianapolis; University of Minnesota (T.R.H.), Minneapolis; Emory University (R.E.G.), Atlanta, GA; University of Kansas (J.M.N.), Kansas City; Weill Cornell (D.L.), New York, NY; Thomas Jefferson University (M.R.S., A.S.), Philadelphia, PA; Marshfield Clinic (E.S.), WI; Veterans Affairs Greater Los Angeles Healthcare System (A.H.); Geffen School of Medicine at UCLA (J.M.S.), Los Angeles, CA; Barrow Neurological Institute (S.C., A.I.T.), Phoenix, AZ; Stanford University (J.M.H., R.F.), CA; NYU Comprehensive Epilepsy Center (J.F.), New York, NY; University of Pennsylvania (G.B., J.R.P.), PA; St. Luke's (W.E.R.), St. Louis, MO; University of California San Francisco (P.G.); University of Virginia School of Medicine (N.B.F., W.J.E.), Charlottesville; Mount Sinai (R.R.G.), New York, NY; and Medtronic, Inc. (C.P.I., K.L., N.G.), Minneapolis, MN.
Steve Chung
From Indiana University (V.S., T.W., R.W., N.M.B.), Indianapolis; University of Minnesota (T.R.H.), Minneapolis; Emory University (R.E.G.), Atlanta, GA; University of Kansas (J.M.N.), Kansas City; Weill Cornell (D.L.), New York, NY; Thomas Jefferson University (M.R.S., A.S.), Philadelphia, PA; Marshfield Clinic (E.S.), WI; Veterans Affairs Greater Los Angeles Healthcare System (A.H.); Geffen School of Medicine at UCLA (J.M.S.), Los Angeles, CA; Barrow Neurological Institute (S.C., A.I.T.), Phoenix, AZ; Stanford University (J.M.H., R.F.), CA; NYU Comprehensive Epilepsy Center (J.F.), New York, NY; University of Pennsylvania (G.B., J.R.P.), PA; St. Luke's (W.E.R.), St. Louis, MO; University of California San Francisco (P.G.); University of Virginia School of Medicine (N.B.F., W.J.E.), Charlottesville; Mount Sinai (R.R.G.), New York, NY; and Medtronic, Inc. (C.P.I., K.L., N.G.), Minneapolis, MN.
Jaimie M. Henderson
From Indiana University (V.S., T.W., R.W., N.M.B.), Indianapolis; University of Minnesota (T.R.H.), Minneapolis; Emory University (R.E.G.), Atlanta, GA; University of Kansas (J.M.N.), Kansas City; Weill Cornell (D.L.), New York, NY; Thomas Jefferson University (M.R.S., A.S.), Philadelphia, PA; Marshfield Clinic (E.S.), WI; Veterans Affairs Greater Los Angeles Healthcare System (A.H.); Geffen School of Medicine at UCLA (J.M.S.), Los Angeles, CA; Barrow Neurological Institute (S.C., A.I.T.), Phoenix, AZ; Stanford University (J.M.H., R.F.), CA; NYU Comprehensive Epilepsy Center (J.F.), New York, NY; University of Pennsylvania (G.B., J.R.P.), PA; St. Luke's (W.E.R.), St. Louis, MO; University of California San Francisco (P.G.); University of Virginia School of Medicine (N.B.F., W.J.E.), Charlottesville; Mount Sinai (R.R.G.), New York, NY; and Medtronic, Inc. (C.P.I., K.L., N.G.), Minneapolis, MN.
Jacqueline French
From Indiana University (V.S., T.W., R.W., N.M.B.), Indianapolis; University of Minnesota (T.R.H.), Minneapolis; Emory University (R.E.G.), Atlanta, GA; University of Kansas (J.M.N.), Kansas City; Weill Cornell (D.L.), New York, NY; Thomas Jefferson University (M.R.S., A.S.), Philadelphia, PA; Marshfield Clinic (E.S.), WI; Veterans Affairs Greater Los Angeles Healthcare System (A.H.); Geffen School of Medicine at UCLA (J.M.S.), Los Angeles, CA; Barrow Neurological Institute (S.C., A.I.T.), Phoenix, AZ; Stanford University (J.M.H., R.F.), CA; NYU Comprehensive Epilepsy Center (J.F.), New York, NY; University of Pennsylvania (G.B., J.R.P.), PA; St. Luke's (W.E.R.), St. Louis, MO; University of California San Francisco (P.G.); University of Virginia School of Medicine (N.B.F., W.J.E.), Charlottesville; Mount Sinai (R.R.G.), New York, NY; and Medtronic, Inc. (C.P.I., K.L., N.G.), Minneapolis, MN.
Gordon Baltuch
From Indiana University (V.S., T.W., R.W., N.M.B.), Indianapolis; University of Minnesota (T.R.H.), Minneapolis; Emory University (R.E.G.), Atlanta, GA; University of Kansas (J.M.N.), Kansas City; Weill Cornell (D.L.), New York, NY; Thomas Jefferson University (M.R.S., A.S.), Philadelphia, PA; Marshfield Clinic (E.S.), WI; Veterans Affairs Greater Los Angeles Healthcare System (A.H.); Geffen School of Medicine at UCLA (J.M.S.), Los Angeles, CA; Barrow Neurological Institute (S.C., A.I.T.), Phoenix, AZ; Stanford University (J.M.H., R.F.), CA; NYU Comprehensive Epilepsy Center (J.F.), New York, NY; University of Pennsylvania (G.B., J.R.P.), PA; St. Luke's (W.E.R.), St. Louis, MO; University of California San Francisco (P.G.); University of Virginia School of Medicine (N.B.F., W.J.E.), Charlottesville; Mount Sinai (R.R.G.), New York, NY; and Medtronic, Inc. (C.P.I., K.L., N.G.), Minneapolis, MN.
William E. Rosenfeld
From Indiana University (V.S., T.W., R.W., N.M.B.), Indianapolis; University of Minnesota (T.R.H.), Minneapolis; Emory University (R.E.G.), Atlanta, GA; University of Kansas (J.M.N.), Kansas City; Weill Cornell (D.L.), New York, NY; Thomas Jefferson University (M.R.S., A.S.), Philadelphia, PA; Marshfield Clinic (E.S.), WI; Veterans Affairs Greater Los Angeles Healthcare System (A.H.); Geffen School of Medicine at UCLA (J.M.S.), Los Angeles, CA; Barrow Neurological Institute (S.C., A.I.T.), Phoenix, AZ; Stanford University (J.M.H., R.F.), CA; NYU Comprehensive Epilepsy Center (J.F.), New York, NY; University of Pennsylvania (G.B., J.R.P.), PA; St. Luke's (W.E.R.), St. Louis, MO; University of California San Francisco (P.G.); University of Virginia School of Medicine (N.B.F., W.J.E.), Charlottesville; Mount Sinai (R.R.G.), New York, NY; and Medtronic, Inc. (C.P.I., K.L., N.G.), Minneapolis, MN.
Paul Garcia
From Indiana University (V.S., T.W., R.W., N.M.B.), Indianapolis; University of Minnesota (T.R.H.), Minneapolis; Emory University (R.E.G.), Atlanta, GA; University of Kansas (J.M.N.), Kansas City; Weill Cornell (D.L.), New York, NY; Thomas Jefferson University (M.R.S., A.S.), Philadelphia, PA; Marshfield Clinic (E.S.), WI; Veterans Affairs Greater Los Angeles Healthcare System (A.H.); Geffen School of Medicine at UCLA (J.M.S.), Los Angeles, CA; Barrow Neurological Institute (S.C., A.I.T.), Phoenix, AZ; Stanford University (J.M.H., R.F.), CA; NYU Comprehensive Epilepsy Center (J.F.), New York, NY; University of Pennsylvania (G.B., J.R.P.), PA; St. Luke's (W.E.R.), St. Louis, MO; University of California San Francisco (P.G.); University of Virginia School of Medicine (N.B.F., W.J.E.), Charlottesville; Mount Sinai (R.R.G.), New York, NY; and Medtronic, Inc. (C.P.I., K.L., N.G.), Minneapolis, MN.
Nicholas M. Barbaro
From Indiana University (V.S., T.W., R.W., N.M.B.), Indianapolis; University of Minnesota (T.R.H.), Minneapolis; Emory University (R.E.G.), Atlanta, GA; University of Kansas (J.M.N.), Kansas City; Weill Cornell (D.L.), New York, NY; Thomas Jefferson University (M.R.S., A.S.), Philadelphia, PA; Marshfield Clinic (E.S.), WI; Veterans Affairs Greater Los Angeles Healthcare System (A.H.); Geffen School of Medicine at UCLA (J.M.S.), Los Angeles, CA; Barrow Neurological Institute (S.C., A.I.T.), Phoenix, AZ; Stanford University (J.M.H., R.F.), CA; NYU Comprehensive Epilepsy Center (J.F.), New York, NY; University of Pennsylvania (G.B., J.R.P.), PA; St. Luke's (W.E.R.), St. Louis, MO; University of California San Francisco (P.G.); University of Virginia School of Medicine (N.B.F., W.J.E.), Charlottesville; Mount Sinai (R.R.G.), New York, NY; and Medtronic, Inc. (C.P.I., K.L., N.G.), Minneapolis, MN.
Nathan B. Fountain
From Indiana University (V.S., T.W., R.W., N.M.B.), Indianapolis; University of Minnesota (T.R.H.), Minneapolis; Emory University (R.E.G.), Atlanta, GA; University of Kansas (J.M.N.), Kansas City; Weill Cornell (D.L.), New York, NY; Thomas Jefferson University (M.R.S., A.S.), Philadelphia, PA; Marshfield Clinic (E.S.), WI; Veterans Affairs Greater Los Angeles Healthcare System (A.H.); Geffen School of Medicine at UCLA (J.M.S.), Los Angeles, CA; Barrow Neurological Institute (S.C., A.I.T.), Phoenix, AZ; Stanford University (J.M.H., R.F.), CA; NYU Comprehensive Epilepsy Center (J.F.), New York, NY; University of Pennsylvania (G.B., J.R.P.), PA; St. Luke's (W.E.R.), St. Louis, MO; University of California San Francisco (P.G.); University of Virginia School of Medicine (N.B.F., W.J.E.), Charlottesville; Mount Sinai (R.R.G.), New York, NY; and Medtronic, Inc. (C.P.I., K.L., N.G.), Minneapolis, MN.
W. Jeffrey Elias
From Indiana University (V.S., T.W., R.W., N.M.B.), Indianapolis; University of Minnesota (T.R.H.), Minneapolis; Emory University (R.E.G.), Atlanta, GA; University of Kansas (J.M.N.), Kansas City; Weill Cornell (D.L.), New York, NY; Thomas Jefferson University (M.R.S., A.S.), Philadelphia, PA; Marshfield Clinic (E.S.), WI; Veterans Affairs Greater Los Angeles Healthcare System (A.H.); Geffen School of Medicine at UCLA (J.M.S.), Los Angeles, CA; Barrow Neurological Institute (S.C., A.I.T.), Phoenix, AZ; Stanford University (J.M.H., R.F.), CA; NYU Comprehensive Epilepsy Center (J.F.), New York, NY; University of Pennsylvania (G.B., J.R.P.), PA; St. Luke's (W.E.R.), St. Louis, MO; University of California San Francisco (P.G.); University of Virginia School of Medicine (N.B.F., W.J.E.), Charlottesville; Mount Sinai (R.R.G.), New York, NY; and Medtronic, Inc. (C.P.I., K.L., N.G.), Minneapolis, MN.
Robert R. Goodman
From Indiana University (V.S., T.W., R.W., N.M.B.), Indianapolis; University of Minnesota (T.R.H.), Minneapolis; Emory University (R.E.G.), Atlanta, GA; University of Kansas (J.M.N.), Kansas City; Weill Cornell (D.L.), New York, NY; Thomas Jefferson University (M.R.S., A.S.), Philadelphia, PA; Marshfield Clinic (E.S.), WI; Veterans Affairs Greater Los Angeles Healthcare System (A.H.); Geffen School of Medicine at UCLA (J.M.S.), Los Angeles, CA; Barrow Neurological Institute (S.C., A.I.T.), Phoenix, AZ; Stanford University (J.M.H., R.F.), CA; NYU Comprehensive Epilepsy Center (J.F.), New York, NY; University of Pennsylvania (G.B., J.R.P.), PA; St. Luke's (W.E.R.), St. Louis, MO; University of California San Francisco (P.G.); University of Virginia School of Medicine (N.B.F., W.J.E.), Charlottesville; Mount Sinai (R.R.G.), New York, NY; and Medtronic, Inc. (C.P.I., K.L., N.G.), Minneapolis, MN.
John R. Pollard
From Indiana University (V.S., T.W., R.W., N.M.B.), Indianapolis; University of Minnesota (T.R.H.), Minneapolis; Emory University (R.E.G.), Atlanta, GA; University of Kansas (J.M.N.), Kansas City; Weill Cornell (D.L.), New York, NY; Thomas Jefferson University (M.R.S., A.S.), Philadelphia, PA; Marshfield Clinic (E.S.), WI; Veterans Affairs Greater Los Angeles Healthcare System (A.H.); Geffen School of Medicine at UCLA (J.M.S.), Los Angeles, CA; Barrow Neurological Institute (S.C., A.I.T.), Phoenix, AZ; Stanford University (J.M.H., R.F.), CA; NYU Comprehensive Epilepsy Center (J.F.), New York, NY; University of Pennsylvania (G.B., J.R.P.), PA; St. Luke's (W.E.R.), St. Louis, MO; University of California San Francisco (P.G.); University of Virginia School of Medicine (N.B.F., W.J.E.), Charlottesville; Mount Sinai (R.R.G.), New York, NY; and Medtronic, Inc. (C.P.I., K.L., N.G.), Minneapolis, MN.
Alexander I. Tröster
From Indiana University (V.S., T.W., R.W., N.M.B.), Indianapolis; University of Minnesota (T.R.H.), Minneapolis; Emory University (R.E.G.), Atlanta, GA; University of Kansas (J.M.N.), Kansas City; Weill Cornell (D.L.), New York, NY; Thomas Jefferson University (M.R.S., A.S.), Philadelphia, PA; Marshfield Clinic (E.S.), WI; Veterans Affairs Greater Los Angeles Healthcare System (A.H.); Geffen School of Medicine at UCLA (J.M.S.), Los Angeles, CA; Barrow Neurological Institute (S.C., A.I.T.), Phoenix, AZ; Stanford University (J.M.H., R.F.), CA; NYU Comprehensive Epilepsy Center (J.F.), New York, NY; University of Pennsylvania (G.B., J.R.P.), PA; St. Luke's (W.E.R.), St. Louis, MO; University of California San Francisco (P.G.); University of Virginia School of Medicine (N.B.F., W.J.E.), Charlottesville; Mount Sinai (R.R.G.), New York, NY; and Medtronic, Inc. (C.P.I., K.L., N.G.), Minneapolis, MN.
Christopher P. Irwin
From Indiana University (V.S., T.W., R.W., N.M.B.), Indianapolis; University of Minnesota (T.R.H.), Minneapolis; Emory University (R.E.G.), Atlanta, GA; University of Kansas (J.M.N.), Kansas City; Weill Cornell (D.L.), New York, NY; Thomas Jefferson University (M.R.S., A.S.), Philadelphia, PA; Marshfield Clinic (E.S.), WI; Veterans Affairs Greater Los Angeles Healthcare System (A.H.); Geffen School of Medicine at UCLA (J.M.S.), Los Angeles, CA; Barrow Neurological Institute (S.C., A.I.T.), Phoenix, AZ; Stanford University (J.M.H., R.F.), CA; NYU Comprehensive Epilepsy Center (J.F.), New York, NY; University of Pennsylvania (G.B., J.R.P.), PA; St. Luke's (W.E.R.), St. Louis, MO; University of California San Francisco (P.G.); University of Virginia School of Medicine (N.B.F., W.J.E.), Charlottesville; Mount Sinai (R.R.G.), New York, NY; and Medtronic, Inc. (C.P.I., K.L., N.G.), Minneapolis, MN.
Kristin Lambrecht
From Indiana University (V.S., T.W., R.W., N.M.B.), Indianapolis; University of Minnesota (T.R.H.), Minneapolis; Emory University (R.E.G.), Atlanta, GA; University of Kansas (J.M.N.), Kansas City; Weill Cornell (D.L.), New York, NY; Thomas Jefferson University (M.R.S., A.S.), Philadelphia, PA; Marshfield Clinic (E.S.), WI; Veterans Affairs Greater Los Angeles Healthcare System (A.H.); Geffen School of Medicine at UCLA (J.M.S.), Los Angeles, CA; Barrow Neurological Institute (S.C., A.I.T.), Phoenix, AZ; Stanford University (J.M.H., R.F.), CA; NYU Comprehensive Epilepsy Center (J.F.), New York, NY; University of Pennsylvania (G.B., J.R.P.), PA; St. Luke's (W.E.R.), St. Louis, MO; University of California San Francisco (P.G.); University of Virginia School of Medicine (N.B.F., W.J.E.), Charlottesville; Mount Sinai (R.R.G.), New York, NY; and Medtronic, Inc. (C.P.I., K.L., N.G.), Minneapolis, MN.
Nina Graves
From Indiana University (V.S., T.W., R.W., N.M.B.), Indianapolis; University of Minnesota (T.R.H.), Minneapolis; Emory University (R.E.G.), Atlanta, GA; University of Kansas (J.M.N.), Kansas City; Weill Cornell (D.L.), New York, NY; Thomas Jefferson University (M.R.S., A.S.), Philadelphia, PA; Marshfield Clinic (E.S.), WI; Veterans Affairs Greater Los Angeles Healthcare System (A.H.); Geffen School of Medicine at UCLA (J.M.S.), Los Angeles, CA; Barrow Neurological Institute (S.C., A.I.T.), Phoenix, AZ; Stanford University (J.M.H., R.F.), CA; NYU Comprehensive Epilepsy Center (J.F.), New York, NY; University of Pennsylvania (G.B., J.R.P.), PA; St. Luke's (W.E.R.), St. Louis, MO; University of California San Francisco (P.G.); University of Virginia School of Medicine (N.B.F., W.J.E.), Charlottesville; Mount Sinai (R.R.G.), New York, NY; and Medtronic, Inc. (C.P.I., K.L., N.G.), Minneapolis, MN.
Robert Fisher
From Indiana University (V.S., T.W., R.W., N.M.B.), Indianapolis; University of Minnesota (T.R.H.), Minneapolis; Emory University (R.E.G.), Atlanta, GA; University of Kansas (J.M.N.), Kansas City; Weill Cornell (D.L.), New York, NY; Thomas Jefferson University (M.R.S., A.S.), Philadelphia, PA; Marshfield Clinic (E.S.), WI; Veterans Affairs Greater Los Angeles Healthcare System (A.H.); Geffen School of Medicine at UCLA (J.M.S.), Los Angeles, CA; Barrow Neurological Institute (S.C., A.I.T.), Phoenix, AZ; Stanford University (J.M.H., R.F.), CA; NYU Comprehensive Epilepsy Center (J.F.), New York, NY; University of Pennsylvania (G.B., J.R.P.), PA; St. Luke's (W.E.R.), St. Louis, MO; University of California San Francisco (P.G.); University of Virginia School of Medicine (N.B.F., W.J.E.), Charlottesville; Mount Sinai (R.R.G.), New York, NY; and Medtronic, Inc. (C.P.I., K.L., N.G.), Minneapolis, MN.
From Indiana University (V.S., T.W., R.W., N.M.B.), Indianapolis; University of Minnesota (T.R.H.), Minneapolis; Emory University (R.E.G.), Atlanta, GA; University of Kansas (J.M.N.), Kansas City; Weill Cornell (D.L.), New York, NY; Thomas Jefferson University (M.R.S., A.S.), Philadelphia, PA; Marshfield Clinic (E.S.), WI; Veterans Affairs Greater Los Angeles Healthcare System (A.H.); Geffen School of Medicine at UCLA (J.M.S.), Los Angeles, CA; Barrow Neurological Institute (S.C., A.I.T.), Phoenix, AZ; Stanford University (J.M.H., R.F.), CA; NYU Comprehensive Epilepsy Center (J.F.), New York, NY; University of Pennsylvania (G.B., J.R.P.), PA; St. Luke's (W.E.R.), St. Louis, MO; University of California San Francisco (P.G.); University of Virginia School of Medicine (N.B.F., W.J.E.), Charlottesville; Mount Sinai (R.R.G.), New York, NY; and Medtronic, Inc. (C.P.I., K.L., N.G.), Minneapolis, MN.
Long-term efficacy and safety of thalamic stimulation for drug-resistant partial epilepsy
Vicenta Salanova, Thomas Witt, Robert Worth, Thomas R. Henry, Robert E. Gross, Jules M. Nazzaro, Douglas Labar, Michael R. Sperling, Ashwini Sharan, Evan Sandok, Adrian Handforth, John M. Stern, Steve Chung, Jaimie M. Henderson, Jacqueline French, Gordon Baltuch, William E. Rosenfeld, Paul Garcia, Nicholas M. Barbaro, Nathan B. Fountain, W. Jeffrey Elias, Robert R. Goodman, John R. Pollard, Alexander I. Tröster, Christopher P. Irwin, Kristin Lambrecht, Nina Graves, Robert Fisher, For the SANTE Study Group
Neurology Mar 2015, 84 (10) 1017-1025; DOI: 10.1212/WNL.0000000000001334
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Abstract
Objective: To report long-term efficacy and safety results of the SANTE trial investigating deep brain stimulation of the anterior nucleus of the thalamus (ANT) for treatment of localization-related epilepsy.
Methods: This long-term follow-up is a continuation of a previously reported trial of 5- vs 0-V ANT stimulation. Long-term follow-up began 13 months after device implantation with stimulation parameters adjusted at the investigators' discretion. Seizure frequency was determined using daily seizure diaries.
Results: The median percent seizure reduction from baseline at 1 year was 41%, and 69% at 5 years. The responder rate (≥50% reduction in seizure frequency) at 1 year was 43%, and 68% at 5 years. In the 5 years of follow-up, 16% of subjects were seizure-free for at least 6 months. There were no reported unanticipated adverse device effects or symptomatic intracranial hemorrhages. The Liverpool Seizure Severity Scale and 31-item Quality of Life in Epilepsy measure showed statistically significant improvement over baseline by 1 year and at 5 years (p < 0.001).
Conclusion: Long-term follow-up of ANT deep brain stimulation showed sustained efficacy and safety in a treatment-resistant population.
Classification of evidence: This long-term follow-up provides Class IV evidence that for patients with drug-resistant partial epilepsy, anterior thalamic stimulation is associated with a 69% reduction in seizure frequency and a 34% serious device-related adverse event rate at 5 years.
GLOSSARY
- ANT=
- anterior nucleus of the thalamus;
- CI=
- confidence interval;
- DBS=
- deep brain stimulation;
- LSSS=
- Liverpool Seizure Severity Scale;
- QOLIE-31=
- 31-item Quality of Life in Epilepsy;
- SAE=
- serious adverse event;
- SANTE=
- Stimulation of the Anterior Nucleus of the Thalamus for Epilepsy;
- SUDEP=
- sudden unexpected death in epilepsy;
- VNS=
- vagus nerve stimulation
Footnotes
SANTE Study Group coinvestigators and contributors are listed on the Neurology® Web site at Neurology.org.
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Supplemental data at Neurology.org
- Received April 12, 2014.
- Accepted in final form November 13, 2014.
- © 2015 American Academy of Neurology
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