biostudies-literatureUnknown11(1)Sadeghzadeh S<h4>Objectives</h4>Pivotal trials have established the effectiveness of the Responsive Neurostimulation System (RNS® System) in treating focal epilepsy. In clinical trials, depth leads were primarily used to treat mesial temporal seizure onsets while cortical strip leads were used to treat neocortical seizure onsets. Here, we systematically analyze the safety and efficacy of stereoelectroencephalography (sEEG)-guided depth leads to provide responsive stimulation to neocortical gray matter.<h4>Methods</h4>Patients were stratified as strong responders (>median cohort seizure reduction %), weak responders (>0% and ≤median cohort seizure reduction %), and anti-responders (≤0%) based on percent seizure reduction at 1 year post-implant (1-Y). Pre-operative T1-weighted magnetic resonance imaging Epilepsia open146-161https://www.ebi.ac.uk/biostudies/studies/S-EPMC12903807biostudies-literaturesEEG-guided responsive neurostimulation to treat neocortical epilepsy: A multicenter retrospective study of the efficacy and safety of depth electrode-mediated neuromodulation.PMC12903807Halpern CHJohnson NGhatan SWu CSchonfeld EAbikenari MAJobst BCJain BGerrard JSather MDParker JJGray TEWillie JTPark JJDrees CBuch VPRaslan AMFisher TLSkidmore CTHines KSadeghzadeh SPurger DAQuraishi IHBarbosa DANOjemann SGHuang YBhanot PYoo JYKarakis IGraber KDAronson JPfalsesEEG-guided responsive neurostimulation to treat neocortical epilepsy: A multicenter retrospective study of the efficacy and safety of depth electrode-mediated neuromodulation.<h4>Objectives</h4>Pivotal trials have established the effectiveness of the Responsive Neurostimulation System (RNS® System) in treating focal epilepsy. In clinical trials, depth leads were primarily used to treat mesial temporal seizure onsets while cortical strip leads were used to treat neocortical seizure onsets. Here, we systematically analyze the safety and efficacy of stereoelectroencephalography (sEEG)-guided depth leads to provide responsive stimulation to neocortical gray matter.<h4>Methods</h4>Patients were stratified as strong responders (>median cohort seizure reduction %), weak responders (>0% and ≤median cohort seizure reduction %), and anti-responders (≤0%) based on percent seizure reduction at 1 year post-implant (1-Y). Pre-operative T1-weighted magnetic resonance imaging 2026-01-01T00:00:00Z2026 Feb2026-07-15T18:08:05.313Z2026-07-08T03:08:46.76ZS-EPMC129038074125119210.1002/epi4.70180