Fabrice Bartolomei

The efficacy and safety of ANT-DBS in patients who have also failed VNS remain insufficiently explored, and the effect compared to BMT is not known. In 61 patients, 45% of patients in the ANT-DBS group achieved a ≥50% reduction in severe monthly seizure frequency compared to 27% in the BMT group (p: not significant). ANT-DBS showed a statistically significant reduction in seizure frequency relative to baseline at 12 months (−44%) and 24 months (−46%), which was not achieved in the BMT group.

Personalized multichannel tDCS reduced seizure frequency by 20% overall; 37% of patients were responders, with one seizure-free case. Significant improvements in quality of life (QOLIE-31), particularly in patients with lower baseline scores, were observed. The study confirmed the safety of personalized tDCS, with mostly mild adverse events, including skin-related issues and headaches.

Symptom network analysis is a quantitative tool derived from graph theory, applied here for the first time to prefrontal seizure semiology and SEEG data. Semiological features were combined with neural data to model a hybrid network, quantifying expected influence centrality. In the prefrontal semiological network, impairment of consciousness emerged as the most central feature. In the prefrontal hybrid network, anterior cingulate was the most central brain feature.