Epilepsia
September 3, 2026 · via Europe PMC
Low-frequency centromedian stimulation in patients with generalized or multifocal drug-resistant epilepsy previously submitted to high-frequency stimulation: A prospective study.
Vieira JV, Oliveira JPS, Guimarães RB, Capitão PS, Burattini JA, Cukiert CM, Cukiert A.
AI summary — for doctors, generated from the abstract only
Switching centromedian thalamic DBS from high to low frequency maintained or improved seizure control in some patients with generalized or multifocal drug-resistant epilepsy while cutting battery use.
What was studied
A prospective open-label within-subject study of 10 patients with generalized or multifocal DRE on CM-DBS who were switched from 130-180 Hz to 6-10 Hz stimulation.
Key findings
- Four patients with absence seizures improved in the first month
- One patient worsened transiently then had 50% improvement from month 3
- Four patients had no significant change; one was excluded for behavioral deterioration
- Generator energy consumption fell substantially; VABS-III changes were not significant
Clinical relevance
Suggests low-frequency CM-DBS may be a more energy-efficient option in selected patients; tiny open-label study requires randomized confirmation.
Who should care
Limitations
Very small, open-label, uncontrolled study with one exclusion for adverse behavior.
Low-frequency CM-DBS deserves testing in larger randomized trials.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Objective
Drug-resistant epilepsy (DRE) remains a significant clinical challenge, affecting approximately 30% of patients. Deep brain stimulation (DBS) of the centromedian thalamic nucleus (CM) has emerged as a viable therapy for generalized and multifocal seizures. Although high-frequency stimulation (HFS) is the clinical standard, emerging evidence suggests that low-frequency stimulation (LFS) may offer comparable efficacy with improved safety and battery longevity.
Methods
We conducted a prospective, open-label, within-subject study involving 10 patients with generalized or multifocal DRE already treated with CM-DBS. Patients were transitioned from HFS (130-180 Hz) to LFS (6-10 Hz). Primary outcomes included seizure frequency reduction and safety. Secondary outcomes assessed behavioral and cognitive changes using the Vineland Adaptive Behavior Scales, Third Edition (VABS-III).
Results
Four patients with absence seizures (44%) had an improvement in seizure frequency noted immediately in the 1st month. One patient (11%) had a transient deterioration in absence seizure frequency in the 1st month but from the 3rd month onward had a 50% improvement compared to the baseline. The other four patients did not have any significant change in any seizure frequency. A substantial reduction in implantable pulse generator energy consumption was observed. Caregivers reported qualitative improvements in social behavior and cognitive engagement, although VABS-III scores did not reach statistical significance. One patient was excluded due to behavioral deterioration during the LFS transition phase.
Significance
This is the first prospective study addressing the efficacy and safety of low-frequency (LF) versus high-frequency CM-DBS in patients with generalized or multifocal epilepsy. LF CM-DBS is a potentially safer and more energy-efficient alternative to HFS, maintaining clinical efficacy in selected patients with generalized or multifocal DRE. These findings warrant further investigation through larger, randomized, double-blind trials.
DOI
10.1002/epi.70476
PMID
42693600
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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