OBJECTIVE: To identify features of ablations and trajectories that correlate with optimal seizure control and minimize the risk of neurocognitive deficits in patients undergoing laser interstitial thermal therapy (LiTT) for mesiotemporal epilepsy (mTLE). METHODS: Clinical and radiographic data were reviewed from a prospectively maintained database of all patients undergoing LiTT for the treatment of mTLE at the University of Miami Hospital. Standard preoperative and postoperative evaluations, including contrast-enhanced magnetic resonance imaging (MRI) and neuropsychological testing, were performed in all patients. Laser trajectory and ablation volumes were computed both by manual tracing of mesiotemporal structures and by nonrigid registration of ablation cavities to a common reference system based on 7T MRI data. RESULTS: Among 23 patients with at least 1-year follow-up, 15 (65%) were free of disabling seizures since the time of their surgery. Sparing of the mesial hippocampal head was significantly correlated with persistent disabling seizures (p = 0.01). A lateral trajectory through the hippocampus showed a trend for poor seizure outcome (p = 0.08). A comparison of baseline and postoperative neurocognitive testing revealed areas of both improvement and worsening, which were not associated with ablation volume or trajectory. SIGNIFICANCE: At 1-year follow-up, LiTT appears to be a safe and effective tool for the treatment of mTLE, although a longer follow-up period is necessary to confirm these observations. Better understanding of the impact of ablation volume and location could potentially fine-tune this technique to improve seizure-freedom rates and associated neurologic and cognitive changes. Wiley Periodicals, Inc.
OBJECTIVE: To identify features of ablations and trajectories that correlate with optimal seizure control and minimize the risk of neurocognitive deficits in patients undergoing laser interstitial thermal therapy (LiTT) for mesiotemporal epilepsy (mTLE). METHODS: Clinical and radiographic data were reviewed from a prospectively maintained database of all patients undergoing LiTT for the treatment of mTLE at the University of Miami Hospital. Standard preoperative and postoperative evaluations, including contrast-enhanced magnetic resonance imaging (MRI) and neuropsychological testing, were performed in all patients. Laser trajectory and ablation volumes were computed both by manual tracing of mesiotemporal structures and by nonrigid registration of ablation cavities to a common reference system based on 7T MRI data. RESULTS: Among 23 patients with at least 1-year follow-up, 15 (65%) were free of disabling seizures since the time of their surgery. Sparing of the mesial hippocampal head was significantly correlated with persistent disabling seizures (p = 0.01). A lateral trajectory through the hippocampus showed a trend for poor seizure outcome (p = 0.08). A comparison of baseline and postoperative neurocognitive testing revealed areas of both improvement and worsening, which were not associated with ablation volume or trajectory. SIGNIFICANCE: At 1-year follow-up, LiTT appears to be a safe and effective tool for the treatment of mTLE, although a longer follow-up period is necessary to confirm these observations. Better understanding of the impact of ablation volume and location could potentially fine-tune this technique to improve seizure-freedom rates and associated neurologic and cognitive changes. Wiley Periodicals, Inc.
Authors: Martin T Lutz; Hans Clusmann; Christian E Elger; Johannes Schramm; Christoph Helmstaedter Journal: Epilepsia Date: 2004-07 Impact factor: 5.864
Authors: Björn von Rhein; Michael Nelles; Horst Urbach; Marec Von Lehe; Johannes Schramm; Christoph Helmstaedter Journal: J Neurol Neurosurg Psychiatry Date: 2012-07-08 Impact factor: 10.154
Authors: Pierre-François D'Haese; Srivatsan Pallavaram; Rui Li; Michael S Remple; Chris Kao; Joseph S Neimat; Peter E Konrad; Benoit M Dawant Journal: Med Image Anal Date: 2010-08-01 Impact factor: 8.545
Authors: Giovanni B Frisoni; Clifford R Jack; Martina Bocchetta; Corinna Bauer; Kristian S Frederiksen; Yawu Liu; Gregory Preboske; Tim Swihart; Melanie Blair; Enrica Cavedo; Michel J Grothe; Mariangela Lanfredi; Oliver Martinez; Masami Nishikawa; Marileen Portegies; Travis Stoub; Chadwich Ward; Liana G Apostolova; Rossana Ganzola; Dominik Wolf; Frederik Barkhof; George Bartzokis; Charles DeCarli; John G Csernansky; Leyla deToledo-Morrell; Mirjam I Geerlings; Jeffrey Kaye; Ronald J Killiany; Stephane Lehéricy; Hiroshi Matsuda; John O'Brien; Lisa C Silbert; Philip Scheltens; Hilkka Soininen; Stefan Teipel; Gunhild Waldemar; Andreas Fellgiebel; Josephine Barnes; Michael Firbank; Lotte Gerritsen; Wouter Henneman; Nikolai Malykhin; Jens C Pruessner; Lei Wang; Craig Watson; Henrike Wolf; Mony deLeon; Johannes Pantel; Clarissa Ferrari; Paolo Bosco; Patrizio Pasqualetti; Simon Duchesne; Henri Duvernoy; Marina Boccardi Journal: Alzheimers Dement Date: 2014-09-27 Impact factor: 21.566
Authors: Jon T Willie; Nealen G Laxpati; Daniel L Drane; Ashok Gowda; Christina Appin; Chunhai Hao; Daniel J Brat; Sandra L Helmers; Amit Saindane; Sherif G Nour; Robert E Gross Journal: Neurosurgery Date: 2014-06 Impact factor: 4.654
Authors: Srivatsan Pallavaram; Pierre-François DʼHaese; Wendell Lake; Peter E Konrad; Benoit M Dawant; Joseph S Neimat Journal: Neurosurgery Date: 2015-06 Impact factor: 4.654
Authors: Colin B Josephson; Jonathan Dykeman; Kirsten M Fiest; Xiaorong Liu; R Mark Sadler; Nathalie Jette; Samuel Wiebe Journal: Neurology Date: 2013-04-03 Impact factor: 9.910
Authors: Benhur D Henz; Paul A Friedman; Charles J Bruce; David R Holmes; Mark Bower; Malini Madhavan; Christopher V DeSimone; Douglas Wahnschaffe; Steven Berhow; Andrew J Danielsen; Dorothy J Ladewig; Susan B Mikell; Susan B Johnson; Scott H Suddendorf; Tomas Kara; Gregory A Worrell; Samuel J Asirvatham Journal: Epilepsy Res Date: 2014-04-27 Impact factor: 3.045
Authors: Daniel L Drane; David W Loring; Natalie L Voets; Michele Price; Jeffrey G Ojemann; Jon T Willie; Amit M Saindane; Vaishali Phatak; Mirjana Ivanisevic; Scott Millis; Sandra L Helmers; John W Miller; Kimford J Meador; Robert E Gross Journal: Epilepsia Date: 2014-12-08 Impact factor: 5.864
Authors: Hepzibha Alexander; Kelsey Cobourn; Islam Fayed; Dewi Depositario-Cabacar; Robert F Keating; William D Gaillard; Chima O Oluigbo Journal: Childs Nerv Syst Date: 2019-01-09 Impact factor: 1.475
Authors: Chengyuan Wu; Walter J Jermakowicz; Srijata Chakravorti; Iahn Cajigas; Ashwini D Sharan; Jonathan R Jagid; Caio M Matias; Michael R Sperling; Robert Buckley; Andrew Ko; Jeffrey G Ojemann; John W Miller; Brett Youngerman; Sameer A Sheth; Guy M McKhann; Adrian W Laxton; Daniel E Couture; Gautam S Popli; Alexander Smith; Ashesh D Mehta; Allen L Ho; Casey H Halpern; Dario J Englot; Joseph S Neimat; Peter E Konrad; Elliot Neal; Fernando L Vale; Kathryn L Holloway; Ellen L Air; Jason Schwalb; Benoit M Dawant; Pierre-Francois D'Haese Journal: Epilepsia Date: 2019-05-21 Impact factor: 5.864
Authors: Robert E Gross; Matthew A Stern; Jon T Willie; Rebecca E Fasano; Amit M Saindane; Bruno P Soares; Nigel P Pedersen; Daniel L Drane Journal: Ann Neurol Date: 2018-03-03 Impact factor: 10.422
Authors: Eric Prince; Shahin Hakimian; Andrew L Ko; Jeffrey G Ojemann; Michelle S Kim; John W Miller Journal: Curr Neurol Neurosci Rep Date: 2017-09 Impact factor: 5.081