Optimized stereoelectroencephalography-guided thermocoagulation versus anterior temporal lobectomy in mesial temporal epilepsy: A pilot randomized controlled study

作者：Yongzhi Shan, Jianwei Shi, Tianren Wang, Sichang Chen, Tao Feng, Lu Yin, Liankun Ren, Penghu Wei, Yanfeng Yang, Hongxing Wang, Guoguang Zhao · 发表于：Journal of Advanced Research · 年份：2025 · DOI：10.1016/j.jare.2025.06.042 · 被引用次数：3 · 研究领域：Epilepsy research and treatment、Glioma Diagnosis and Treatment、EEG and Brain-Computer Interfaces

INTRODUCTION: Anterior temporal lobectomy (ATL) is the standard surgical treatment for drug-resistant mesial temporal lobe epilepsy (MTLE); however, it is associated with cognitive decline and visual field deficits. In the current era of personalized medicine and quality-of-life-focused care, minimally invasive surgical strategies are increasingly needed. Optimized stereoelectroencephalography (SEEG)-guided radiofrequency thermocoagulation (RF-TC) is a promising option for preserving cognitive and visual function while providing effective seizure control. OBJECTIVES: Methods: This assessor-blinded randomized, controlled pilot trial enrolled patients with drug-resistant MTLE at Xuanwu Hospital between August 2019 and October 2022. Participants were randomly allocated (1:1) to the ATL or SEEG-guided RF-TC groups. The primary outcome was the change in cognitive function at the 1-year follow-up, assessed using the Chinese version of the Wechsler Adult Intelligence Scale-IV (WAIS-IV-C). Secondary outcomes included the Wechsler Memory Scale-IV (WMS-IV-C), seizure control (Engel classification), visual fields (Humphrey perimetry), quality of life (QOLIE-89), and adverse events. RESULTS: Thirty-eight patients (19 male [50.0 %]; mean [standard deviation] age, 28.3 [7.1] years) were enrolled, with 20 and 18 patients assigned to the ATL and RF-TC groups, respectively. At 1 year, the overall WAIS-IV-C scores did not differ between the ATL and RF-TC groups (P > 0.050). However, patients w...