Abstract

The Seizure and Cognitive Outcome of Anterior Thalamic Nucleus Deep Brain Stimulation for Patients with Intractable Epilepsy

Author(s): Yuguang Guan, Sichang Chen, Yao Zhang, Changqing Liu, Jingjing Gu, Meng Zhao, Jing Wang, Mengyang Wang, Junhong Pan, Guoming Luan

Objectives:

The objective of this study was to evaluate the efficacy of anterior thalamic nucleus deep brain stimulation (ANT-DBS) for patients with intractable epilepsy based on seizure and cognitive outcomes.

Patients and Methods:

Seventeen patients suffering from intractable epilepsy who received ANT-DBS implants from April 2015 to October 2016 were retrospectively reviewed. The preoperative evaluation consisted of semiology, electroencephalogram (EEG), positron emission tomography (PET) and MRI. During follow-up over 0.6-1 years, the surgical effects were evaluated mainly based on the seizure outcome (McHugh classification); psychological examinations including Wechsler Adult Intelligence Scale (WAIS), the Hamilton Anxiety Scale (HAMA), the Hamilton Depression Scale (HAMD), and quality of life (QOL).

Results:

The results showed that there was complete seizure free in 1 case, and temporal seizure free in 1 case. The average seizure improvement was 56%. Five (29.4%), 4 (23.5%), 6 (35.3%), 1 (5.9%), and 1 (5.9%) patients were classified into McHugh classes I, II, III, IV, and V, respectively. Complex partial seizure and temporal lobe epilepsy may have better seizure outcomes. The average postoperative IQ was slightly higher than that before operation, and the quality of life was statistically improved after ANT-DBS.

Conclusions:

The outcomes showed obvious seizure improvement with cognitive gain. ANT-DBS appears to be an effective and promising therapy for intractable epilepsy.