Introduction: Responsive Neurostimulation (RNS) is an emerging technology for the treatment of drug-resistant epilepsy (DRE). There is a paucity of literature regarding the post-operative neurocognitive effects of RNS implantation in epilepsy patients.
Methods: We completed a retrospective chart review of patients with drug resistant epilepsy implanted with the RNS system at our institution between 2017 and 2024 who underwent both pre and post operative neuropsychiatric evaluations (n=14). Variables examined included general abilities, attention, memory, language, visual spatial/construction naming, executive function, and motor skills.
Results: 79% of our patients were male (n=11). The mean age at implantation of RNS was 39.1 years of age. 43% of patients (n=6) had bilateral hippocampal RNS depth leads placed. Mean seizure reduction in our cohort was 74% (±20). Mean follow-up time for post operative neuropsychiatric evaluation was 14.3 months. There was statistically significant decreases in VCI Sum Scaled Score, VCI normalized to IQ, AMNART and Rey Figure Copy tests and a statistically significant increase in the Arithmetic Scaled score. Only the reduction in AMNART was clinically significant based off reported MCID.
Conclusion : RNS procedure is associated with statistically significant changes across multiple neuropsychology paradigms. Future research is needed to further elucidate these trends.
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