Magnetic resonance‐guided laser interstitial thermal therapy for drug‐resistant epilepsy: A systematic review and individual participant data meta‐analysis.
Saved in:
| Title: | Magnetic resonance‐guided laser interstitial thermal therapy for drug‐resistant epilepsy: A systematic review and individual participant data meta‐analysis. |
|---|---|
| Authors: | Chen, Jia‐Shu (AUTHOR), Lamoureux, Audrey‐Anne (AUTHOR), Shlobin, Nathan A. (AUTHOR), Elkaim, Lior M. (AUTHOR), Wang, Andrew (AUTHOR), Ibrahim, George M. (AUTHOR), Obaid, Sami (AUTHOR), Harroud, Adil (AUTHOR), Guadagno, Elena (AUTHOR), Dimentberg, Evan (AUTHOR), Bouthillier, Alain (AUTHOR), Bernhardt, Boris C. (AUTHOR), Nguyen, Dang K. (AUTHOR), Fallah, Aria (AUTHOR), Weil, Alexander G. (AUTHOR) |
| Source: | Epilepsia (Series 4). Aug2023, Vol. 64 Issue 8, p1957-1974. 18p. |
| Subjects: | Temporal lobectomy, Hippocampal sclerosis, Epilepsy, Magnetic resonance imaging, Ablation techniques, Epilepsy surgery |
| Abstract: | Magnetic resonance‐guided laser interstitial thermal therapy (MRgLITT) has emerged as a popular minimally invasive alternative to open resective surgery for drug‐resistant epilepsy (DRE). We sought to perform a systematic review and individual participant data meta‐analysis to identify independent predictors of seizure outcome and complications following MRgLITT for DRE. Eleven databases were searched from January 1, 2010 to February 6, 2021 using the terms "MR‐guided ablation therapy" and "epilepsy". Multivariable mixed‐effects Cox and logistic regression identified predictors of time to seizure recurrence, seizure freedom, operative complications, and postoperative neurological deficits. From 8705 citations, 46 studies reporting on 450 MRgLITT DRE patients (mean age = 29.5 ± 18.1 years, 49.6% female) were included. Median postoperative seizure freedom and follow‐up duration were 15.5 and 19.0 months, respectively. Overall, 240 (57.8%) of 415 patients (excluding palliative corpus callosotomy) were seizure‐free at last follow‐up. Generalized seizure semiology (hazard ratio [HR] = 1.78, p =.020) and nonlesional magnetic resonance imaging (MRI) findings (HR = 1.50, p =.032) independently predicted shorter time to seizure recurrence. Cerebral cavernous malformation (CCM; odds ratio [OR] = 7.97, p <.001) and mesial temporal sclerosis/atrophy (MTS/A; OR = 2.21, p =.011) were independently associated with greater odds of seizure freedom at last follow‐up. Operative complications occurred in 28 (8.5%) of 330 patients and were independently associated with extratemporal ablations (OR = 5.40, p =.012) and nonlesional MRI studies (OR = 3.25, p =.017). Postoperative neurological deficits were observed in 53 (15.1%) of 352 patients and were independently predicted by hypothalamic hamartoma etiology (OR = 5.93, p =.006) and invasive electroencephalographic monitoring (OR = 4.83, p =.003). Overall, MRgLITT is particularly effective in treating patients with well‐circumscribed lesional DRE, such as CCM and MTS/A, but less effective in nonlesional cases or lesional cases with a more diffuse epileptogenic network associated with generalized seizures. This study identifies independent predictors of seizure freedom and complications following MRgLITT that may help further guide patient selection. [ABSTRACT FROM AUTHOR] |
| Copyright of Epilepsia (Series 4) is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Psychology and Behavioral Sciences Collection |
|
Full text is not displayed to guests.
Login for full access.
|
|
| FullText | Links: – Type: pdflink Text: Availability: 1 |
|---|---|
| Header | DbId: pbh DbLabel: Psychology and Behavioral Sciences Collection An: 169827806 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
| IllustrationInfo | |
| Items | – Name: Title Label: Title Group: Ti Data: Magnetic resonance‐guided laser interstitial thermal therapy for drug‐resistant epilepsy: A systematic review and individual participant data meta‐analysis. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Chen%2C+Jia‐Shu%22">Chen, Jia‐Shu</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lamoureux%2C+Audrey‐Anne%22">Lamoureux, Audrey‐Anne</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Shlobin%2C+Nathan+A%2E%22">Shlobin, Nathan A.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Elkaim%2C+Lior+M%2E%22">Elkaim, Lior M.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Wang%2C+Andrew%22">Wang, Andrew</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Ibrahim%2C+George+M%2E%22">Ibrahim, George M.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Obaid%2C+Sami%22">Obaid, Sami</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Harroud%2C+Adil%22">Harroud, Adil</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Guadagno%2C+Elena%22">Guadagno, Elena</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Dimentberg%2C+Evan%22">Dimentberg, Evan</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Bouthillier%2C+Alain%22">Bouthillier, Alain</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Bernhardt%2C+Boris+C%2E%22">Bernhardt, Boris C.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Nguyen%2C+Dang+K%2E%22">Nguyen, Dang K.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Fallah%2C+Aria%22">Fallah, Aria</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Weil%2C+Alexander+G%2E%22">Weil, Alexander G.</searchLink> (AUTHOR) – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Epilepsia+%28Series+4%29%22">Epilepsia (Series 4)</searchLink>. Aug2023, Vol. 64 Issue 8, p1957-1974. 18p. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Temporal+lobectomy%22">Temporal lobectomy</searchLink><br /><searchLink fieldCode="DE" term="%22Hippocampal+sclerosis%22">Hippocampal sclerosis</searchLink><br /><searchLink fieldCode="DE" term="%22Epilepsy%22">Epilepsy</searchLink><br /><searchLink fieldCode="DE" term="%22Magnetic+resonance+imaging%22">Magnetic resonance imaging</searchLink><br /><searchLink fieldCode="DE" term="%22Ablation+techniques%22">Ablation techniques</searchLink><br /><searchLink fieldCode="DE" term="%22Epilepsy+surgery%22">Epilepsy surgery</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Magnetic resonance‐guided laser interstitial thermal therapy (MRgLITT) has emerged as a popular minimally invasive alternative to open resective surgery for drug‐resistant epilepsy (DRE). We sought to perform a systematic review and individual participant data meta‐analysis to identify independent predictors of seizure outcome and complications following MRgLITT for DRE. Eleven databases were searched from January 1, 2010 to February 6, 2021 using the terms "MR‐guided ablation therapy" and "epilepsy". Multivariable mixed‐effects Cox and logistic regression identified predictors of time to seizure recurrence, seizure freedom, operative complications, and postoperative neurological deficits. From 8705 citations, 46 studies reporting on 450 MRgLITT DRE patients (mean age = 29.5 ± 18.1 years, 49.6% female) were included. Median postoperative seizure freedom and follow‐up duration were 15.5 and 19.0 months, respectively. Overall, 240 (57.8%) of 415 patients (excluding palliative corpus callosotomy) were seizure‐free at last follow‐up. Generalized seizure semiology (hazard ratio [HR] = 1.78, p =.020) and nonlesional magnetic resonance imaging (MRI) findings (HR = 1.50, p =.032) independently predicted shorter time to seizure recurrence. Cerebral cavernous malformation (CCM; odds ratio [OR] = 7.97, p <.001) and mesial temporal sclerosis/atrophy (MTS/A; OR = 2.21, p =.011) were independently associated with greater odds of seizure freedom at last follow‐up. Operative complications occurred in 28 (8.5%) of 330 patients and were independently associated with extratemporal ablations (OR = 5.40, p =.012) and nonlesional MRI studies (OR = 3.25, p =.017). Postoperative neurological deficits were observed in 53 (15.1%) of 352 patients and were independently predicted by hypothalamic hamartoma etiology (OR = 5.93, p =.006) and invasive electroencephalographic monitoring (OR = 4.83, p =.003). Overall, MRgLITT is particularly effective in treating patients with well‐circumscribed lesional DRE, such as CCM and MTS/A, but less effective in nonlesional cases or lesional cases with a more diffuse epileptogenic network associated with generalized seizures. This study identifies independent predictors of seizure freedom and complications following MRgLITT that may help further guide patient selection. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Epilepsia (Series 4) is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
| PLink | https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=169827806 |
| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1111/epi.17560 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 18 StartPage: 1957 Subjects: – SubjectFull: Temporal lobectomy Type: general – SubjectFull: Hippocampal sclerosis Type: general – SubjectFull: Epilepsy Type: general – SubjectFull: Magnetic resonance imaging Type: general – SubjectFull: Ablation techniques Type: general – SubjectFull: Epilepsy surgery Type: general Titles: – TitleFull: Magnetic resonance‐guided laser interstitial thermal therapy for drug‐resistant epilepsy: A systematic review and individual participant data meta‐analysis. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Chen, Jia‐Shu – PersonEntity: Name: NameFull: Lamoureux, Audrey‐Anne – PersonEntity: Name: NameFull: Shlobin, Nathan A. – PersonEntity: Name: NameFull: Elkaim, Lior M. – PersonEntity: Name: NameFull: Wang, Andrew – PersonEntity: Name: NameFull: Ibrahim, George M. – PersonEntity: Name: NameFull: Obaid, Sami – PersonEntity: Name: NameFull: Harroud, Adil – PersonEntity: Name: NameFull: Guadagno, Elena – PersonEntity: Name: NameFull: Dimentberg, Evan – PersonEntity: Name: NameFull: Bouthillier, Alain – PersonEntity: Name: NameFull: Bernhardt, Boris C. – PersonEntity: Name: NameFull: Nguyen, Dang K. – PersonEntity: Name: NameFull: Fallah, Aria – PersonEntity: Name: NameFull: Weil, Alexander G. IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 08 Text: Aug2023 Type: published Y: 2023 Identifiers: – Type: issn-print Value: 00139580 Numbering: – Type: volume Value: 64 – Type: issue Value: 8 Titles: – TitleFull: Epilepsia (Series 4) Type: main |
| ResultId | 1 |
