Functional connectomic profile correlates with effective anterior thalamic stimulation for refractory epilepsy

作者：Xu Cuiping, Lei Qi, Xueyuan Wang, Frédéric Schaper, Di Wu, Tao Yu, Xiaoming Yan, Guangyuan Jin, Qiao Wang, Xiaopeng Wang, Xinqi Huang, Yuke Wang, Yuanhong Chen, Jinghui Liu, Yuping Wang, Andreas Horn, Robert S. Fisher, Liankun Ren · 发表于：Brain stimulation · 年份：2023 · DOI：10.1016/j.brs.2023.08.020 · 被引用次数：19 · 研究领域：Neurological disorders and treatments、Functional Brain Connectivity Studies、Epilepsy research and treatment

BACKGROUND: Deep brain stimulation of the anterior nucleus of the thalamus (ANT-DBS) is an effective treatment for refractory epilepsy; however, seizure outcome varies among individuals. Identifying a reliable noninvasive biomarker to predict good responders would be helpful. OBJECTIVES: To test whether the functional connectivity between the ANT-DBS sites and the seizure foci correlates with effective seizure control in refractory epilepsy. METHODS: We performed a proof-of-concept pilot study of patients with focal refractory epilepsy receiving ANT-DBS. Using normative human connectome data derived from 1000 healthy participants, we investigated whether intrinsic functional connectivity between the seizure foci and the DBS site was associated with seizure outcome. We repeated this analysis controlling for the extent of seizure foci, distance between the seizure foci and DBS site, and using functional connectivity of the ANT instead of the DBS site to test the contribution of variance in DBS sites. RESULTS: Eighteen patients with two or more seizure foci were included. Greater functional connectivity between the seizure foci and the DBS site correlated with more favorable outcome. The degree of functional connectivity accounted for significant variance in clinical outcomes (DBS site: |r| = 0.773, p < 0.001 vs ANT-atlas: |r| = 0.715, p = 0.001), which remained significant when controlling for the extent of the seizure foci (|r| = 0.773, p < 0.001) and the distance between the ...