Clinical outcomes and resting-state brain activity alterations following centromedian thalamic nucleus deep brain stimulation in drug-resistant epilepsyOA
Background:To assess the clinical efficacy of centromedian nucleus deep brain stimulation(CM-DBS)for drugresistant epilepsy and explore its effects on neural activity using resting-state functional magnetic resonance imaging.Methods:Ten patients,comprising four with Lennox–Gastaut syndrome(LGS),three with generalized epilepsy(GE)and three with multifocal epilepsy,underwent CM-DBS using thalamic segmentation for localization.Efficacy was assessed by calculating seizure frequency reduction from baseline.Two measures of resting brain activity—the amplitude of low-frequency fluctuations(ALFF),reflecting the strength of spontaneous brain signals,and regional homogeneity(ReHo),indicating the synchrony of neighboring brain regions—were analyzed to evaluate postoperative changes.Results:Mean seizure reduction across all patients was 61.8%.Six patients,comprising four with LGS and two with GE,demonstrated>50%reduction in seizure frequency.ALFF decreased in the right putamen,left inferior temporal,left putamen,right supplementary motor area,right para-hippocampal gyrus,right thalamus,left superior frontal gyrus,left cerebellar vermis IV–V,and right post cingulate gyrus.ReHo decreased in the left inferior temporal gyrus,left anterior cingulate gyrus,and right cerebellar lobe III but increased in the left inferior occipital gyrus,left middle occipital gyrus,right middle occipital gyrus,left cuneus,and right calcarine.Conclusions:Our preliminary findings in a small cohort show that CM-DBS may be effective for certain drugresistant epilepsies,such as LGS and GE.Thalamic segmentation also enhanced visualization of target structures for clinical use.ALFF/ReHo changes reflect neural reorganization and reveal key epileptic network nodes,potentially reducing CM-DBS seizure frequency.
Changquan Wang;Yun Luo;Bin Chen;Wenzhe Chen;Jing Hong;Nan Wang;Ziyu Mao;Wenzhen Chen;Chencheng Zhang;Jiwen Xu
Department of Neurosurgery,Comprehensive Epilepsy Unit,Ruijin Hospital Luwan Branch,Shanghai Jiao Tong University School of Medicine,Shanghai 200001,ChinaClinical Neuroscience Center,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200001,ChinaDepartment of Neurosurgery,Comprehensive Epilepsy Unit,Ruijin Hospital Luwan Branch,Shanghai Jiao Tong University School of Medicine,Shanghai 200001,ChinaDepartment of Neurosurgery,Comprehensive Epilepsy Unit,Ruijin Hospital Luwan Branch,Shanghai Jiao Tong University School of Medicine,Shanghai 200001,ChinaDepartment of Neurosurgery,Comprehensive Epilepsy Unit,Ruijin Hospital Luwan Branch,Shanghai Jiao Tong University School of Medicine,Shanghai 200001,China Department of Neurosurgery,Clinical Neuroscience Center Comprehensive Epilepsy Unit,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200001,ChinaDepartment of Neurosurgery,Comprehensive Epilepsy Unit,Ruijin Hospital Luwan Branch,Shanghai Jiao Tong University School of Medicine,Shanghai 200001,ChinaDepartment of Neurosurgery,Comprehensive Epilepsy Unit,Ruijin Hospital Luwan Branch,Shanghai Jiao Tong University School of Medicine,Shanghai 200001,ChinaDepartment of Neurosurgery,Comprehensive Epilepsy Unit,Ruijin Hospital Luwan Branch,Shanghai Jiao Tong University School of Medicine,Shanghai 200001,China Department of Neurosurgery,Clinical Neuroscience Center Comprehensive Epilepsy Unit,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200001,ChinaDepartment of Neurosurgery,Center for Functional Neurosurgery,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200001,China Shanghai Research Center for Brain Science and Brain-Inspired Technology,Shanghai 200001,ChinaDepartment of Neurosurgery,Comprehensive Epilepsy Unit,Ruijin Hospital Luwan Branch,Shanghai Jiao Tong University School of Medicine,Shanghai 200001,China Department of Neurosurgery,Clinical Neuroscience Center Comprehensive Epilepsy Unit,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200001,China
医药卫生
Drug-resistant epilepsyCentromedian nucleusDeep brain stimulationAmplitude of low frequency fluctuationsRegional homogeneity
《Journal of Neurorestoratology》 2026 (2)
P.39-48,10
funded by the Youth Fund of the Health Commission of Huangpu District,Shanghai(HLQ202203)the Outstanding Youth Talent Training Program of Ruijin Hospital Luwan Branch,Shanghai Jiao Tong University School of Medicine(YQ202313,YQ202301)the Key Medical Talent Program of the Health Commission of Huangpu District,Shanghai(2023GG02).
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