{"id":"https://openalex.org/W7208738174","doi":"https://doi.org/10.1002/epi.70476","title":"Low\u2010frequency centromedian stimulation in patients with generalized or multifocal drug\u2010resistant epilepsy previously submitted to high\u2010frequency stimulation: A prospective study","display_name":"Low\u2010frequency centromedian stimulation in patients with generalized or multifocal drug\u2010resistant epilepsy previously submitted to high\u2010frequency stimulation: A prospective study","publication_year":2026,"publication_date":"2026-09-03","ids":{"openalex":"https://openalex.org/W7208738174","doi":"https://doi.org/10.1002/epi.70476","pmid":"https://pubmed.ncbi.nlm.nih.gov/42693600"},"language":"en","primary_location":{"id":"doi:10.1002/epi.70476","doi":"https://doi.org/10.1002/epi.70476","is_oa":true,"landing_page_url":"https://doi.org/10.1002/epi.70476","pdf_url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/epi.70476","source":{"id":"https://openalex.org/S203153751","display_name":"Epilepsia","issn_l":"0013-9580","issn":["0013-9580","1528-1157","1528-1167"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-b","doyens","jufo-2","ki-jl-1","medline","norway-1","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320595","host_organization_name":"Wiley","host_organization_lineage":["https://openalex.org/P4310320595"],"host_organization_lineage_names":["Wiley"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Epilepsia","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"bronze","oa_url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/epi.70476","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5080660447","display_name":"Julia Vescovi Vieira","orcid":"https://orcid.org/0000-0003-4569-1119","observed_orcids":["https://orcid.org/0000-0003-4569-1119"]},"institutions":[],"countries":[],"is_corresponding":true,"raw_author_name":"Julia Vescovi Vieira","raw_affiliation_strings":["Department of Neurology, Epilepsy Surgery Program Cl\u00ednica Cukiert  S\u00e3o Paulo S\u00e3o Paulo Brazil"],"raw_orcid":"https://orcid.org/0000-0003-4569-1119","affiliations":[{"raw_affiliation_string":"Department of Neurology, Epilepsy Surgery Program Cl\u00ednica Cukiert  S\u00e3o Paulo S\u00e3o Paulo Brazil","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5081261410","display_name":"Jo\u00e3o Paulo Santiago de Oliveira","orcid":"https://orcid.org/0000-0001-6555-3480","observed_orcids":["https://orcid.org/0000-0001-6555-3480"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Jo\u00e3o Paulo Santiago Oliveira","raw_affiliation_strings":["Department of Neurology, Epilepsy Surgery Program Cl\u00ednica Cukiert  S\u00e3o Paulo S\u00e3o Paulo Brazil"],"raw_orcid":"https://orcid.org/0000-0001-6555-3480","affiliations":[{"raw_affiliation_string":"Department of Neurology, Epilepsy Surgery Program Cl\u00ednica Cukiert  S\u00e3o Paulo S\u00e3o Paulo Brazil","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5008371914","display_name":"Rafael Basilio Guimar\u00e3es","orcid":"https://orcid.org/0000-0002-0196-312X","observed_orcids":["https://orcid.org/0000-0002-0196-312X"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Rafael Bas\u00edlio Guimar\u00e3es","raw_affiliation_strings":["Department of Neurology, Epilepsy Surgery Program Cl\u00ednica Cukiert  S\u00e3o Paulo S\u00e3o Paulo Brazil"],"raw_orcid":"https://orcid.org/0000-0002-0196-312X","affiliations":[{"raw_affiliation_string":"Department of Neurology, Epilepsy Surgery Program Cl\u00ednica Cukiert  S\u00e3o Paulo S\u00e3o Paulo Brazil","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5124815591","display_name":"Pamela Spina Capitao","orcid":"https://orcid.org/0009-0002-1977-3516","observed_orcids":["https://orcid.org/0009-0002-1977-3516"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"P\u00e2mela Spina Capit\u00e3o","raw_affiliation_strings":["Department of Neurology, Epilepsy Surgery Program Cl\u00ednica Cukiert  S\u00e3o Paulo S\u00e3o Paulo Brazil"],"raw_orcid":"https://orcid.org/0009-0002-1977-3516","affiliations":[{"raw_affiliation_string":"Department of Neurology, Epilepsy Surgery Program Cl\u00ednica Cukiert  S\u00e3o Paulo S\u00e3o Paulo Brazil","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5082928069","display_name":"Jos\u00e9 Augusto Burattini","orcid":"https://orcid.org/0009-0000-5355-9551","observed_orcids":["https://orcid.org/0009-0000-5355-9551"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Jos\u00e9 Augusto Burattini","raw_affiliation_strings":["Department of Neurology, Epilepsy Surgery Program Cl\u00ednica Cukiert  S\u00e3o Paulo S\u00e3o Paulo Brazil"],"raw_orcid":"https://orcid.org/0009-0000-5355-9551","affiliations":[{"raw_affiliation_string":"Department of Neurology, Epilepsy Surgery Program Cl\u00ednica Cukiert  S\u00e3o Paulo S\u00e3o Paulo Brazil","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5009943089","display_name":"Cristine Mella Cukiert","orcid":"https://orcid.org/0009-0008-3480-1283","observed_orcids":["https://orcid.org/0009-0008-3480-1283"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Cristine Mella Cukiert","raw_affiliation_strings":["Department of Neurology, Epilepsy Surgery Program Cl\u00ednica Cukiert  S\u00e3o Paulo S\u00e3o Paulo Brazil"],"raw_orcid":"https://orcid.org/0009-0008-3480-1283","affiliations":[{"raw_affiliation_string":"Department of Neurology, Epilepsy Surgery Program Cl\u00ednica Cukiert  S\u00e3o Paulo S\u00e3o Paulo Brazil","institution_ids":[]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5026286171","display_name":"Arthur Cukiert","orcid":"https://orcid.org/0000-0002-6563-4149","observed_orcids":["https://orcid.org/0000-0002-6563-4149"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Arthur Cukiert","raw_affiliation_strings":["Department of Neurology, Epilepsy Surgery Program Cl\u00ednica Cukiert  S\u00e3o Paulo S\u00e3o Paulo Brazil"],"raw_orcid":"https://orcid.org/0000-0002-6563-4149","affiliations":[{"raw_affiliation_string":"Department of Neurology, Epilepsy Surgery Program Cl\u00ednica Cukiert  S\u00e3o Paulo S\u00e3o Paulo Brazil","institution_ids":[]}]}],"institutions":[],"countries_distinct_count":0,"institutions_distinct_count":0,"corresponding_author_ids":["https://openalex.org/A5080660447"],"corresponding_institution_ids":[],"apc_list":{"value":4360,"currency":"USD","value_usd":4360},"apc_paid":null,"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10919","display_name":"Deep Brain Stimulation and Movement Disorders","score":0.8988999724388123,"subfield":{"id":"https://openalex.org/subfields/2728","display_name":"Clinical Neurology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10919","display_name":"Deep Brain Stimulation and Movement Disorders","score":0.8988999724388123,"subfield":{"id":"https://openalex.org/subfields/2728","display_name":"Clinical Neurology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10094","display_name":"Epilepsy research and treatment","score":0.09489999711513519,"subfield":{"id":"https://openalex.org/subfields/2728","display_name":"Clinical Neurology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12580","display_name":"Vagus Nerve Stimulation Research","score":0.0020000000949949026,"subfield":{"id":"https://openalex.org/subfields/2808","display_name":"Neurology"},"field":{"id":"https://openalex.org/fields/28","display_name":"Neuroscience"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/drug-resistant-epilepsy","display_name":"drug-resistant epilepsy","score":0.8999999761581421},{"id":"https://openalex.org/keywords/deep-brain-stimulation","display_name":"deep brain stimulation","score":0.8040000200271606},{"id":"https://openalex.org/keywords/centromedian-thalamic-nucleus","display_name":"centromedian thalamic nucleus","score":0.9639999866485596},{"id":"https://openalex.org/keywords/low-frequency-stimulation","display_name":"low-frequency stimulation","score":0.9860000014305115},{"id":"https://openalex.org/keywords/high-frequency-stimulation","display_name":"high-frequency stimulation","score":0.9980000257492065},{"id":"https://openalex.org/keywords/generalized-epilepsy","display_name":"generalized epilepsy","score":0.6740000247955322},{"id":"https://openalex.org/keywords/multifocal-epilepsy","display_name":"multifocal epilepsy","score":0.949999988079071},{"id":"https://openalex.org/keywords/absence-seizures","display_name":"absence seizures","score":0.9710000157356262},{"id":"https://openalex.org/keywords/seizure-frequency","display_name":"seizure frequency","score":0.7699999809265137},{"id":"https://openalex.org/keywords/battery-energy-consumption","display_name":"battery consumption","score":0.7179999947547913}],"concepts":[{"id":"https://openalex.org/C2778186239","wikidata":"https://www.wikidata.org/wiki/Q41571","display_name":"Epilepsy","level":2,"score":0.6561999917030334},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.5873000025749207},{"id":"https://openalex.org/C188816634","wikidata":"https://www.wikidata.org/wiki/Q2113324","display_name":"Prospective cohort study","level":2,"score":0.5785999894142151},{"id":"https://openalex.org/C187212893","wikidata":"https://www.wikidata.org/wiki/Q123028","display_name":"Pediatrics","level":1,"score":0.4871000051498413},{"id":"https://openalex.org/C2778542668","wikidata":"https://www.wikidata.org/wiki/Q618076","display_name":"Deep brain stimulation","level":4,"score":0.46140000224113464},{"id":"https://openalex.org/C42219234","wikidata":"https://www.wikidata.org/wiki/Q131130","display_name":"Anesthesia","level":1,"score":0.4124000072479248},{"id":"https://openalex.org/C24998067","wikidata":"https://www.wikidata.org/wiki/Q4114622","display_name":"Stimulation","level":2,"score":0.4083999991416931},{"id":"https://openalex.org/C2780317758","wikidata":"https://www.wikidata.org/wiki/Q3339235","display_name":"Neurological disorder","level":3,"score":0.3840000033378601},{"id":"https://openalex.org/C2910833928","wikidata":"https://www.wikidata.org/wiki/Q18975053","display_name":"Drug Resistant Epilepsy","level":3,"score":0.37619999051094055},{"id":"https://openalex.org/C2779281540","wikidata":"https://www.wikidata.org/wiki/Q5062122","display_name":"Central nervous system disease","level":2,"score":0.34470000863075256},{"id":"https://openalex.org/C169900460","wikidata":"https://www.wikidata.org/wiki/Q2200417","display_name":"Cognition","level":2,"score":0.33820000290870667},{"id":"https://openalex.org/C535046627","wikidata":"https://www.wikidata.org/wiki/Q30612","display_name":"Clinical trial","level":2,"score":0.3325999975204468},{"id":"https://openalex.org/C15744967","wikidata":"https://www.wikidata.org/wiki/Q9418","display_name":"Psychology","level":0,"score":0.33219999074935913},{"id":"https://openalex.org/C548259974","wikidata":"https://www.wikidata.org/wiki/Q569965","display_name":"Audiology","level":1,"score":0.32170000672340393},{"id":"https://openalex.org/C2985799443","wikidata":"https://www.wikidata.org/wiki/Q4955838","display_name":"Brain stimulation","level":3,"score":0.30709999799728394},{"id":"https://openalex.org/C197934379","wikidata":"https://www.wikidata.org/wiki/Q2047938","display_name":"Adverse effect","level":2,"score":0.299699991941452},{"id":"https://openalex.org/C2779979230","wikidata":"https://www.wikidata.org/wiki/Q5532415","display_name":"Generalized epilepsy","level":3,"score":0.2809999883174896},{"id":"https://openalex.org/C2780375056","wikidata":"https://www.wikidata.org/wiki/Q905905","display_name":"Neuromodulation","level":3,"score":0.27720001339912415},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.2736000120639801},{"id":"https://openalex.org/C2780837902","wikidata":"https://www.wikidata.org/wiki/Q421663","display_name":"Vigabatrin","level":4,"score":0.2718000113964081},{"id":"https://openalex.org/C2777010014","wikidata":"https://www.wikidata.org/wiki/Q852376","display_name":"Convulsion","level":3,"score":0.26030001044273376},{"id":"https://openalex.org/C522805319","wikidata":"https://www.wikidata.org/wiki/Q179965","display_name":"Electroencephalography","level":2,"score":0.2556000053882599},{"id":"https://openalex.org/C2776202747","wikidata":"https://www.wikidata.org/wiki/Q3064951","display_name":"Psychomotor retardation","level":3,"score":0.2502000033855438}],"mesh":[],"locations_count":2,"locations":[{"id":"doi:10.1002/epi.70476","doi":"https://doi.org/10.1002/epi.70476","is_oa":true,"landing_page_url":"https://doi.org/10.1002/epi.70476","pdf_url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/epi.70476","source":{"id":"https://openalex.org/S203153751","display_name":"Epilepsia","issn_l":"0013-9580","issn":["0013-9580","1528-1157","1528-1167"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-b","doyens","jufo-2","ki-jl-1","medline","norway-1","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320595","host_organization_name":"Wiley","host_organization_lineage":["https://openalex.org/P4310320595"],"host_organization_lineage_names":["Wiley"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Epilepsia","raw_type":"journal-article"},{"id":"pmid:42693600","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42693600","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Epilepsia","raw_type":"Journal Article"}],"best_oa_location":{"id":"doi:10.1002/epi.70476","doi":"https://doi.org/10.1002/epi.70476","is_oa":true,"landing_page_url":"https://doi.org/10.1002/epi.70476","pdf_url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/epi.70476","source":{"id":"https://openalex.org/S203153751","display_name":"Epilepsia","issn_l":"0013-9580","issn":["0013-9580","1528-1157","1528-1167"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-b","doyens","jufo-2","ki-jl-1","medline","norway-1","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320595","host_organization_name":"Wiley","host_organization_lineage":["https://openalex.org/P4310320595"],"host_organization_lineage_names":["Wiley"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Epilepsia","raw_type":"journal-article"},"sustainable_development_goals":[{"score":1.0,"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being"}],"study_designs":[{"id":"https://openalex.org/study-designs/clinical-trial","display_name":"Clinical Trial"}],"awards":[],"funders":[],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7208738174.pdf","grobid_xml":"https://content.openalex.org/works/W7208738174.grobid-xml"},"referenced_works_count":9,"referenced_works":["https://openalex.org/W1565390377","https://openalex.org/W2918422895","https://openalex.org/W2996787724","https://openalex.org/W3084220198","https://openalex.org/W3157443081","https://openalex.org/W3196379058","https://openalex.org/W4200266028","https://openalex.org/W4221137253","https://openalex.org/W4399523179"],"related_works":["https://openalex.org/W4223523239","https://openalex.org/W3108239328","https://openalex.org/W4410776083","https://openalex.org/W4412678149","https://openalex.org/W4412978666","https://openalex.org/W4309174633","https://openalex.org/W7134114721","https://openalex.org/W4399580163","https://openalex.org/W2144739538","https://openalex.org/W4416377004"],"abstract_inverted_index":{"OBJECTIVE:":[0],"Drug-resistant":[1],"epilepsy":[2],"(DRE)":[3],"remains":[4],"a":[5,27,63,138,156,247],"significant":[6,171],"clinical":[7,41,257],"challenge,":[8],"affecting":[9],"approximately":[10],"30%":[11],"of":[12,18,231],"patients.":[13],"Deep":[14],"brain":[15],"stimulation":[16,37,48],"(DBS)":[17],"the":[19,40,107,131,146,151,161,215,222,227],"centromedian":[20],"thalamic":[21],"nucleus":[22],"(CM)":[23],"has":[24],"emerged":[25],"as":[26],"viable":[28],"therapy":[29],"for":[30],"generalized":[31,72,240,263],"and":[32,57,97,103,195,229,250],"multifocal":[33,74,242,265],"seizures.":[34],"Although":[35],"high-frequency":[36,235],"(HFS)":[38],"is":[39,221,246],"standard,":[42],"emerging":[43],"evidence":[44],"suggests":[45],"that":[46],"low-frequency":[47,232],"(LFS)":[49],"may":[50],"offer":[51],"comparable":[52],"efficacy":[53,228,258],"with":[54,71,78,118,239,262],"improved":[55],"safety":[56,230],"battery":[58],"longevity.":[59],"METHODS:":[60],"We":[61],"conducted":[62],"prospective,":[64],"open-label,":[65],"within-subject":[66],"study":[67,225],"involving":[68],"10":[69],"patients":[70,117,166,238,261],"or":[73,241,264],"DRE":[75],"already":[76],"treated":[77],"CM-DBS.":[79],"Patients":[80],"were":[81],"transitioned":[82],"from":[83,150],"HFS":[84],"(130-180":[85],"Hz)":[86],"to":[87,160,211,254],"LFS":[88,216],"(6-10":[89],"Hz).":[90],"Primary":[91],"outcomes":[92,100],"included":[93],"seizure":[94,126,143,175],"frequency":[95,127,144],"reduction":[96,179],"safety.":[98],"Secondary":[99],"assessed":[101],"behavioral":[102,212],"cognitive":[104,196],"changes":[105],"using":[106],"Vineland":[108],"Adaptive":[109],"Behavior":[110],"Scales,":[111],"Third":[112],"Edition":[113],"(VABS-III).":[114],"RESULTS:":[115],"Four":[116],"absence":[119,142],"seizures":[120],"(44%)":[121],"had":[122,137,155],"an":[123],"improvement":[124,158],"in":[125,130,141,145,173,180,192,237,259],"noted":[128],"immediately":[129],"1st":[132,147],"month.":[133],"One":[134,206],"patient":[135,207],"(11%)":[136],"transient":[139],"deterioration":[140,213],"month":[148,153],"but":[149],"3rd":[152],"onward":[154],"50%":[157],"compared":[159],"baseline.":[162],"The":[163],"other":[164],"four":[165],"did":[167,201],"not":[168,202],"have":[169],"any":[170,174],"change":[172],"frequency.":[176],"A":[177],"substantial":[178],"implantable":[181],"pulse":[182],"generator":[183],"energy":[184],"consumption":[185],"was":[186,208],"observed.":[187],"Caregivers":[188],"reported":[189],"qualitative":[190],"improvements":[191],"social":[193],"behavior":[194],"engagement,":[197],"although":[198],"VABS-III":[199],"scores":[200],"reach":[203],"statistical":[204],"significance.":[205],"excluded":[209],"due":[210],"during":[214],"transition":[217],"phase.":[218],"SIGNIFICANCE:":[219],"This":[220],"first":[223],"prospective":[224],"addressing":[226],"(LF)":[233],"versus":[234],"CM-DBS":[236,245],"epilepsy.":[243],"LF":[244],"potentially":[248],"safer":[249],"more":[251],"energy-efficient":[252],"alternative":[253],"HFS,":[255],"maintaining":[256],"selected":[260],"DRE.":[266],"These":[267],"findings":[268],"warrant":[269],"further":[270],"investigation":[271],"through":[272],"larger,":[273],"randomized,":[274],"double-blind":[275],"trials.":[276]},"counts_by_year":[],"updated_date":"2026-11-06T12:05:46.655746","created_date":"2026-09-05T00:00:00"}