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European Expert Opinion on ANT-DBS therapy for patients with drug-resistant epilepsy (a Delphi consensus)

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Abstract
Introduction: Although deep brain stimulation of the anterior nucleus of the thalamus (ANT-DBS) represents an established third-line therapy for patients with drug-resistant focal epilepsy, guiding reports on practical treatment principles remain scarce. Methods: An Expert Panel (EP) of 10 European neurologists and 4 neurosurgeons was assembled to share their experience with ANT-DBS therapy. The process included a review of the current literature, which served as a basis for an online survey completed by the EP prior to and following a face-to-face meeting (Delphi method). An agreement level of >= 71 % was considered as consensus. Results: Out of 86 reviewed studies, 46 (53 %) were selected to extract information on the most reported criteria for patient selection, management, and outcome. The Delphi process yielded EP consensus on 4 parameters for selection of good candidates and patient management as well as 7 reasons of concern for this therapy. Since it was not possible to give strict device programming advice due to low levels of evidence, the experts shared their clinical practice: all of them start with monopolar stimulation, 79 % using the cycling mode. Most (93 %) EP members set the initial stimulation frequency and pulse width according to the SANTE parameters, while there is more variability in the amplitudes used. Further agreement was achieved on a list of 7 patient outcome parameters to be monitored during the follow-up. Conclusions: Although current evidence is too low for definite practical guidelines, this EP report could support the selection and management of patients with ANT-DBS.
Keywords
DEEP BRAIN-STIMULATION, ANTERIOR THALAMIC NUCLEUS, ELECTRICAL-STIMULATION, LOBE EPILEPSY, SURGERY, PREDICTORS, OUTCOMES, SAFETY, ANT-DBS, Deep brain stimulation, Epilepsy, Delphi consensus

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MLA
Kaufmann, Elisabeth, et al. “European Expert Opinion on ANT-DBS Therapy for Patients with Drug-Resistant Epilepsy (a Delphi Consensus).” SEIZURE-EUROPEAN JOURNAL OF EPILEPSY, vol. 81, 2020, pp. 201–09, doi:10.1016/j.seizure.2020.08.015.
APA
Kaufmann, E., Bartolomei, F., Boon, P., Chabardes, S., Colon, A. J., Eross, L., … Voges, B. (2020). European Expert Opinion on ANT-DBS therapy for patients with drug-resistant epilepsy (a Delphi consensus). SEIZURE-EUROPEAN JOURNAL OF EPILEPSY, 81, 201–209. https://doi.org/10.1016/j.seizure.2020.08.015
Chicago author-date
Kaufmann, Elisabeth, Fabrice Bartolomei, Paul Boon, Stephan Chabardes, Albert J. Colon, Lorand Eross, Daniel Fab, et al. 2020. “European Expert Opinion on ANT-DBS Therapy for Patients with Drug-Resistant Epilepsy (a Delphi Consensus).” SEIZURE-EUROPEAN JOURNAL OF EPILEPSY 81: 201–9. https://doi.org/10.1016/j.seizure.2020.08.015.
Chicago author-date (all authors)
Kaufmann, Elisabeth, Fabrice Bartolomei, Paul Boon, Stephan Chabardes, Albert J. Colon, Lorand Eross, Daniel Fab, Antonio Goncalves-Ferreira, Lukas L. Imbach, Wim Van Paesschen, Jukka Peltola, Ricardo Rego, Tom Theys, and Berthold Voges. 2020. “European Expert Opinion on ANT-DBS Therapy for Patients with Drug-Resistant Epilepsy (a Delphi Consensus).” SEIZURE-EUROPEAN JOURNAL OF EPILEPSY 81: 201–209. doi:10.1016/j.seizure.2020.08.015.
Vancouver
1.
Kaufmann E, Bartolomei F, Boon P, Chabardes S, Colon AJ, Eross L, et al. European Expert Opinion on ANT-DBS therapy for patients with drug-resistant epilepsy (a Delphi consensus). SEIZURE-EUROPEAN JOURNAL OF EPILEPSY. 2020;81:201–9.
IEEE
[1]
E. Kaufmann et al., “European Expert Opinion on ANT-DBS therapy for patients with drug-resistant epilepsy (a Delphi consensus),” SEIZURE-EUROPEAN JOURNAL OF EPILEPSY, vol. 81, pp. 201–209, 2020.
@article{8685979,
  abstract     = {Introduction: Although deep brain stimulation of the anterior nucleus of the thalamus (ANT-DBS) represents an established third-line therapy for patients with drug-resistant focal epilepsy, guiding reports on practical treatment principles remain scarce. Methods: An Expert Panel (EP) of 10 European neurologists and 4 neurosurgeons was assembled to share their experience with ANT-DBS therapy. The process included a review of the current literature, which served as a basis for an online survey completed by the EP prior to and following a face-to-face meeting (Delphi method). An agreement level of >= 71 % was considered as consensus. Results: Out of 86 reviewed studies, 46 (53 %) were selected to extract information on the most reported criteria for patient selection, management, and outcome. The Delphi process yielded EP consensus on 4 parameters for selection of good candidates and patient management as well as 7 reasons of concern for this therapy. Since it was not possible to give strict device programming advice due to low levels of evidence, the experts shared their clinical practice: all of them start with monopolar stimulation, 79 % using the cycling mode. Most (93 %) EP members set the initial stimulation frequency and pulse width according to the SANTE parameters, while there is more variability in the amplitudes used. Further agreement was achieved on a list of 7 patient outcome parameters to be monitored during the follow-up. Conclusions: Although current evidence is too low for definite practical guidelines, this EP report could support the selection and management of patients with ANT-DBS.},
  author       = {Kaufmann, Elisabeth and Bartolomei, Fabrice and Boon, Paul and Chabardes, Stephan and Colon, Albert J. and Eross, Lorand and Fab, Daniel and Goncalves-Ferreira, Antonio and Imbach, Lukas L. and Van Paesschen, Wim and Peltola, Jukka and Rego, Ricardo and Theys, Tom and Voges, Berthold},
  issn         = {1059-1311},
  journal      = {SEIZURE-EUROPEAN JOURNAL OF EPILEPSY},
  keywords     = {DEEP BRAIN-STIMULATION,ANTERIOR THALAMIC NUCLEUS,ELECTRICAL-STIMULATION,LOBE EPILEPSY,SURGERY,PREDICTORS,OUTCOMES,SAFETY,ANT-DBS,Deep brain stimulation,Epilepsy,Delphi consensus},
  language     = {eng},
  pages        = {201--209},
  title        = {European Expert Opinion on ANT-DBS therapy for patients with drug-resistant epilepsy (a Delphi consensus)},
  url          = {http://dx.doi.org/10.1016/j.seizure.2020.08.015},
  volume       = {81},
  year         = {2020},
}

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