September 21, 2021

The Efficacy, Safety and Outcomes of Brain-Responsive Neurostimulation (RNS® System) Therapy in Older Adults

Summary, originally published in Epilpesia Open

Responsive neurostimulation is approved in patients above 18 years of age with drug resistant focal epilepsy. We aimed to investigate whether RNS outcomes and safety varied based on age. We included patients who had been implanted with RNS for >6 months (N=55), dividing them into older (N=11) and younger adults (N=44) depending on implantation age (?50 and <50 years, respectively). Mean age at implantation in older adults was 54.9±3.5 years. Seizure onset age, epilepsy duration, and comorbidities were significantly higher in older adults (p<0.01). Stimulation parameters, treatment duration and median seizure frequency reduction (76% in older versus 50% in younger adults) were statistically comparable among the two cohorts. Post-treatment, anti-seizure medication burden was significantly decreased in older compared to younger adults (p=0.048). Post-operative and delayed adverse events among older adults were mild. Compared to 3 younger adults, none of the older adults required device explantation due to surgical site infection.

Our study suggests that older adults treated with the RNS System achieve seizure outcomes comparable to younger adults with the additional benefit of a significant post-implantation medication reduction. With efficacy and safety similar to younger adults, brain-responsive neurostimulation was well-tolerated in older adults.

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