RecruitingNot ApplicableNCT06248333

Subthalamic Nucleus Electrical Stimulation for Drug-resistant Focal Motor Epilepsy

Subthalamic Nucleus Electrical Stimulation for Drug-resistant Focal Motor Epilepsy: A Multicenter, Randomized, Double-blind, Sham-controlled, Parallel-group Trial


Sponsor

Xuanwu Hospital, Beijing

Enrollment

33 participants

Start Date

Feb 14, 2024

Study Type

INTERVENTIONAL

Conditions

Summary

The primary objective of this research is to study the efficacy and safety of deep brain stimulation (DBS) of subthalamic nucleus (STN) as adjunctive therapy for reducing the frequency of seizures in drug-resistant focal motor epilepsy.


Eligibility

Min Age: 14 YearsMax Age: 65 Years

Inclusion Criteria14

  • -65 years of age, inclusive, at Screening Visit.
  • Refractory to anti-seizure medications (ASMs).
  • Diagnosed with focal motor epilepsy, which meets the following items:
  • Seizure mainly presents as focal tonic, myoclonic, or primary motor seizure (including primary sensory seizure), with or without secondary bilateral tonic-clonic seizure.
  • After a comprehensive evaluation, the epileptogenic zone was presumed to predominantly involve the unilateral or bilateral central area (precentral gyrus, postcentral gyrus, and paracentral lobule) or supplementary motor area according to comprehensive presurgical evaluation.
  • Within 1 month prior to the Screening Visit (M-3), the following conditions are met:
  • At least 3 focal onset seizures (with or without secondary bilateral tonic-clonic seizure).
  • Subject is receiving at least one type of ASM\[s\], and the regimen has been stable (no addition or removal of ASM\[s\] \[not counting brief rescue medicines such as benzodiazepines\]; dose adjustments are permitted to ASM\[s\]).
  • Within the baseline period (3 months after the Screening Visit \[M-3\]), the following conditions are met:
  • The patient or their caregiver is capable of completing the seizure diary.
  • Seizure diary shows an average of 3 or more partial-onset seizures (with or without secondary bilateral tonic-clonic seizure) per month during the Baseline Period, with no more than 30 days between seizures.
  • The regimen of ASM\[s\] has been stable (no addition or removal of ASM\[s\] \[not counting brief rescue medicines such as benzodiazepines\]; dose adjustments are permitted to ASM\[s\]).
  • After comprehensive preoperative evaluation, patients who are considered unsuitable for or refuse resection surgery, or those for whom the effects of epileptic focus resection and thermocoagulation surgery are not satisfactory.
  • Informed consent signed.

Exclusion Criteria14

  • Diagnosed with generalized or hereditary epilepsy with ion channel gene mutations;
  • Seizures mainly present as complex motor seizures (e.g., hyperkinetic, automatisms, etc.);
  • Tonic-clonic status epilepticus within12 months;
  • Psychogenic non-epileptic seizures within 12 months;
  • Structural lesion of the subthalamic nucleus;
  • Presence of implanted electrical stimulation medical device anywhere in the body (e.g., pacemaker, spinal cord stimulator, responsive neurostimulation) or any metallic implants in the head (e.g., aneurysm clips, cochlear implants). Note: Vagal nerve stimulators are allowed if the parameter remains stable for at least 3 months prior to the screening visit;
  • Risk factors that would put the participant at risk for intraoperative or postoperative bleeding. (e.g., coagulation abnormalities, etc.) or the need for chronic anticoagulation or antiplatelet aggregation medications;
  • IQ < 55 or severe cognitive dysfunction, unable to complete the study;
  • Diagnosed with a progressive neurological disorder (including progressive Rasmussen's encephalitis, etc.);
  • Diagnosed with a severe neuropsychiatric disorder such as dementia, major depression (admission to a psychiatric specialty/hospital within 5 years or any suicidal or self-injurious tendencies), schizophrenia, or neurodegenerative disorders;
  • Diagnosed with other serious physical disorders, internal diseases or severe abnormalities in liver or kidney function;
  • Pregnant, or planning to pregnant within 2 years;
  • Participation in another clinical study within 3 months;
  • Not suitable for enrollment as assessed by the multidisciplinary team of the center.

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Interventions

DEVICESTN-DBS ON

Stimulation ON

DEVICESTN-DBS OFF

Stimulation OFF


Locations(1)

Xuanwu Hospital, Beijing

Beijing, Beijing Municipality, China

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NCT06248333


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