CHILD-DBS [Neurosurgery Wiki]

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====== CHILD-DBS ======

Child & Youth Comprehensive Longitudinal Database for Deep Brain Stimulation

===== Key Points about CHILD-DBS =====

It is a prospective [[clinical registry]], meaning it systematically collects data going forward in time from pediatric patients undergoing deep brain stimulation (DBS).

Focuses specifically on children and adolescents receiving DBS for conditions like drug-resistant epilepsy (DRE).

Tracks not only traditional clinical outcomes (like seizure frequency and severity) but also patient-centered and functional outcomes, such as:

Quality of life

School attendance

Caregiver reports

Allows for longitudinal analysis, capturing how these outcomes evolve over time — in this study, at baseline, 6 months, and 1 year post-surgery.

Also incorporates neuroimaging data to simulate volumes of tissue activation and relate stimulation parameters to outcomes.

In short, CHILD-DBS is a rich, structured platform for studying the real-world impact of DBS in young people, especially when used off-label (as is the case for centromedian nucleus DBS in epilepsy).

===== Prospective observational cohort studies =====

Mithani et al. analyzed data from the prospective [[CHILD-DBS]] (Child & Youth Comprehensive Longitudinal Database for Deep Brain Stimulation) to examine the impact of CM-DBS on patient- and caregiver-reported outcomes.

Twenty-two children and youth underwent bilateral CM-DBS. Caregiver-child dyads completed surveys related to seizure frequency, seizure severity, quality of life, and school attendance at baseline, 6 months, and 1 year postsurgery. Simulated volumes of tissue activation were analyzed to identify optimal stimulation targets associated with treatment outcome.

Of 22 children, 10 experienced ≥50% reduction in seizure frequency (mean reduction = 66.7 ± 17.3%), one exhibited a modest benefit (37.5% reduction), and the remaining 11 experienced no change. The majority (73% of patients) exhibited a clinically important reduction in seizure severity, including six children who did not demonstrate any change in seizure frequency. Only those who experienced a reduction in seizure frequency demonstrated significant improvements in general health and overall quality of life. Furthermore, we observed an increase in school attendance across participants 1 year after CM-DBS.

CM-DBS can lead to a reduction in seizure burden concurrent with improvements in quality of life and relevant functional outcomes in children with DRE. These findings further our understanding of the impact of CM-DBS on meaningful outcomes for children and caregivers
((Mithani K, Niazi F, Suresh H, Alrumayyan Y, Rayco ER, Ochi A, Otsubo H, Kerr E, Breitbart S, LeBlanc-Millar A, Gadgil N, Raskin JS, Weil AG, Hadjinicolaou A, Iorio-Morin C, Weiss S, Jain P, Sham L, Donner E, Fasano A, Gorodetsky C, Ibrahim GM. Deep brain stimulation of the centromedian nucleus for drug-resistant epilepsy in children: Quality-of-life and functional outcomes from the CHILD-DBS registry. Epilepsia. 2025 Apr 1. doi: 10.1111/epi.18393. Epub ahead of print. PMID: 40167366.)).