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Exploring New Ways of Using Responsive Neurostimulation in Epilepsy: Vineet Punia, MD, MS

The neurologist from Cleveland Clinic offered his insight into the areas that he believes responsive neurostimulation could provide benefit to patients that need further examination.

"You want to see the long-term outcomes in terms of cognition or what happens to cognition in patients who undergo RNS implantation. Similarly, we need more long-term data on the mood outcomes of how the mood disturbances play out in these patients because that’s important as well.”

Responsive neurostimulation (RNS) is a breakthrough surgical approach to treating seizures that are not controlled by medication. Patients are considered candidates for RNS when they have undergone comprehensive diagnostic testing that has localized 1 or 2 seizure foci but are determined not to be candidates for surgical resection for a given particular reason. To date, RNS has been used and validated in adults, but not the elderly.

Senior author Vineet Punia, MD, MS, and colleagues recently presented research at the 2021 American Academy of Neurology (AAN) Annual Meeting, April 17-22, which evaluated 57 patients, 12 (21%) of whom were 50 years or older at the time of RNS implantation. Eight (67%) of the older adults had at least 50% seizure reduction, of whom 3 (25%) became seizure-free. Notably, younger adults had more RNS related complications in comparison to older adults (4 versus 0; P <.001).

Punia, a neurologist at Cleveland Clinic, feels as though observing cognition in these patients is the next steps in expanding the use of RNS. He sat down with NeurologyLive to detail the advantages of RNS that are still unclarified to this point.

REFERENCE
Zawar I, Mackow M, Aexopoulos A, Nair D, Punia V. The efficacy, safety and outcomes of responsive neurostimulation (RNS) therapy in older adults. Presented at 2021 American Academy of Neurology Annual Meeting; April 17-22. Abstract P7.057