Bilateral radiofrequency anterior thalamotomy in intractable epilepsy patients

Ситников, А Р; Grigoryan, Yu A; Mishnyakova, L P

doi:10.17116/neiro201680325-34

Cited by 5 publications

(7 citation statements)

References 22 publications

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“…Electrophysiological studies with depth electrode recordings from ANT in patients argues for an important role of ANT in the process of memory encoding 50 . A series from Moscow with ANT radiofrequency lesions of bilateral ANT in seizure patients improved seizures without reported complaints of memory or cognitive problems 18 . However, formal neuropsychological test results were not reported.…”

Section: Discussionmentioning

confidence: 99%

“…50 A series from Moscow with ANT radiofrequency lesions of bilateral ANT in seizure patients improved seizures without reported complaints of memory or cognitive problems. 18 However, formal neuropsychological test results were not reported. Therefore, ANT lesions by any mechanism present a potential risk to memory.…”

Section: Discussionmentioning

confidence: 99%

“…This phenomenon, often referred to as microlesion effect, could persist for 1–3 months after surgery 16 or even up to 36 months, 17 although mechanisms other than microlesions might have played roles in the reduction. More recently, bilateral ANT radiofrequency ablation (RFA) was found to significantly reduce seizures in 12 of 13 patients with frontal or temporal onset epilepsy 18 . ANT DBS and ANT RFA carry the risks of approach‐related morbidity, such as infection and bleeding.…”

Section: Introductionmentioning

confidence: 99%

“…More recently, bilateral ANT radiofrequency ablation (RFA) was found to significantly reduce seizures in 12 of 13 patients with frontal or temporal onset epilepsy. 18 ANT DBS and ANT RFA carry the risks of approach-related morbidity, such as infection and bleeding. ANT DBS also can produce paresthesias and occasionally worsen depression, memory function, or seizures and carries the risk of device-related adverse events (AEs) such as device-related pain and device breakage.…”

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confidence: 99%

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A phase 1 open‐label trial evaluating focused ultrasound unilateral anterior thalamotomy for focal onset epilepsy

et al. 2023

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Objective: Focused ultrasound ablation (FUSA) is an emerging treatment for neurological and psychiatric diseases. We describe the initial experience from a pilot, open-label, single-center clinical trial of unilateral anterior nucleus of the thalamus (ANT) FUSA in patients with treatment-refractory epilepsy.Methods: Two adult subjects with treatment-refractory, focal onset epilepsy were recruited. The subjects received ANT FUSA using the Exablate Neuro (Insightec) system. We determined the safety and feasibility (primary outcomes), and changes in seizure frequency (secondary outcome) at 3, 6, and 12 months. Safety was assessed by the absence of side effects, that is, new onset neurological deficits or performance deterioration on neuropsychological testing. Feasibility was defined as the ability to create a lesion within the anterior nucleus. The monthly seizure frequency was compared between baseline and postthalamotomy. Results:The patients tolerated the procedure well, without neurological deficits or serious adverse events. One patient experienced a decline in verbal fluency, attention/working memory, and immediate verbal memory. Seizure frequency reduced significantly in both patients; one patient was seizure-free at 12 months, and in the second patient, the frequency reduced from 90-100 seizures per month to 3-6 seizures per month. Significance: This is the first known clinical trial to assess the safety, feasibility, and preliminary efficacy of ANT FUSA in adult patients with treatmentrefractory focal onset epilepsy. K E Y W O R D Santerior nucleus, clinical trial, epilepsy, focused ultrasound, thalamotomy | INTRODUCTIONFocal onset seizures represent the most common epilepsy syndrome among adults. 1 Approximately one third of patients with epilepsy eventually become refractory to medication, 2 comprising approximately 400 000 patients (among the 2 million focal epilepsy patients

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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A phase 1 open‐label trial evaluating focused ultrasound unilateral anterior thalamotomy for focal onset epilepsy

et al. 2023

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“…[ 34 ] Based on this research and several animal studies, we started using bilateral stereotactic anterior nucleothalamotomy for treatment of pharmacoresistant epilepsy in humans. [ 40 ]…”

Section: Introductionmentioning

confidence: 99%

Bilateral stereotactic lesions and chronic stimulation of the anterior thalamic nuclei for treatment of pharmacoresistant epilepsy

2018

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Background:The use of the anterior nucleus of thalamus (ANT) as a target for treatment of pharmacoresistant epilepsy is based on its crucial role in seizure propagation. We describe results of chronic bilateral ANT stimulation and bilateral ANT lesions in 31 patients with refractory epilepsy.Methods:ANT DBS was performed in 12 patients (group I) and bilateral stereotactic radiofrequency lesions of ANT were performed in 19 patients (group II). Targeting was based on stereotactic atlas information with correction of the final coordinates according to the location of anatomical landmarks and intraoperative microelectrode recording data.Results:Both groups were similar in age, gender, seizures frequency, and duration of disease. The median x, y, and z coordinates of ANT were found to be 2.9, 5, and 11 mm anterior, lateral, and superior to the mid-commissural point, respectively. Mean seizures reduction reached 80.3% in group of patients with ANT DBS with two nonresponders and 91.2% in group of patients with lesions. Five patients from group I and three patients from group II became seizure-free. The morbidity rate was low in both groups.Conclusions:Stereotactic anterior thalamotomy and chronic ANT stimulation are both effective for seizure control in epilepsy originated from frontal and temporal lobes. ANT lesions and stimulation were more effective for secondary-generalized seizures compared to simple partial seizures.

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Current approaches to neurosurgical treatment for drug-resistant focal epilepsy in adults

Narodova

Narodov

Shnayder

et al. 2018

RJTAO

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Bilateral radiofrequency anterior thalamotomy in intractable epilepsy patients

Cited by 5 publications

References 22 publications

A phase 1 open‐label trial evaluating focused ultrasound unilateral anterior thalamotomy for focal onset epilepsy

A phase 1 open‐label trial evaluating focused ultrasound unilateral anterior thalamotomy for focal onset epilepsy

Bilateral stereotactic lesions and chronic stimulation of the anterior thalamic nuclei for treatment of pharmacoresistant epilepsy

Current approaches to neurosurgical treatment for drug-resistant focal epilepsy in adults

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