| Autor: |
Lara M. Schrader, Steve Chung, Donna Bergen, Robert S. Fisher, Patty Schaefer, Steven Wong, Steven Papavassiliou, Jessica Horsfall, Evan Sandok, Dianne Henry, Mike Smith, Roy A.E. Bakay, Cecelia Fields, Michael G. Kaplitt, Guy M. McKhann, Michele Meyer, John R. Pollard, Andrew Youkilis, Dragos Sabau, Steve Wilkinson, Thomas J. Hoeppner, William E. Rosenfeld, Marc A. Dichter, Diane Sundstrom, Stuart Waltonen, Pam Mundt, Nathan B. Fountain, Mary Komosa, William Schultz, Marvin A. Rossi, Andrea Hurt, Zornitza Timenova, Susan T. Herman, Phani Priya Nekkalapu, Bree Vogelsong, Suzette M. LaRoche, Virginia Balbona, Debbie Livingood, Robert Cox, Jaimie M. Henderson, William J. Marks, Chris Grote, Paul Francel, Carol Young, John M. Stern, Michelle Fulk, Dan Han, Gary Heit, Brian Bridges, Stephanie Marsh, Andro Zangaladze, Sally Frutiger, David M. Treiman, Gordon H. Baltuch, Megan Johnson, Jeanne Ann King, Joan Grebin, Sandra Clements, Donna K. Broshek, Rama Maganti, Eric Kobylarz, John H. Neal, Mark Quigg, Adrian Handforth, Ashwini Sharan, Dawn Cordero, Norman C. Wang, Robert M. Worth, Thomas C. Witt, Vicenta Salanova, Andrea Hovick, John Grant, Marsha Manley, Mimi Callanan, Jeannine Morrone Strupinsky, MaryAnn Kavalir, Penelope Ziefert, Monica Volz, David Kareken, Karen Lapp, Helene Quinn, Raeleen Dolin, Antonio DeSalles, Jules M. Nazzaro, Jennifer Gray, Kristin Kirlin, Lawrence J. Hirsch, Harinder R. Kaur, Kalarickal J. Oommen, Robert E. Gross, Mark E Burdelle, Paul A. Garcia, Evan Drake, Andrew G. Shetter, Charles M. Epstein, Robin Taylor, Stacy Thompson, Lisa Tonder, K. Babu Krishnamurthy, Laura Ponticello, Carl W. Bazil, Patsy Kretschmar, Jean Montgomery, William Elias, Linda Smith, Christopher Skidmore, Padmaja Kandula, Nancy Minniti, Kathy Mancl, Nicolas Barbaro, Patricia Trudeau, Lynette Will, James Scott, Lynette Featherstone, Susan Lippmann, Robert C. Frysinger, Lisa Clift, Bruce Palmer, Andres M. Kanner, Leigh Stott, Robert J. Coffey, Joseph I. Tracy, Douglas Labar, Thomas R. Henry, Kevin Graber, Nina M. Graves, Jacqueline A. French, Carol Macpherson, Michael R. Sperling, Bill Nikolov, Robert R. Goodman, Carla Van Amburg, Deborah A. Cahn-Weiner, Linda Perdue, Scott E. Krahl, Shelley Adderley, Mary Davidson, David Smith, Alison Randall, Kristen Strybing, Ivan Osorio, Timothy Mapstone |
| Rok vydání: |
2010 |
| Předmět: |
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| Zdroj: |
Epilepsia. 51:899-908 |
| ISSN: |
0013-9580 |
| DOI: |
10.1111/j.1528-1167.2010.02536.x |
| Popis: |
Summary Purpose: We report a multicenter, double-blind, randomized trial of bilateral stimulation of the anterior nuclei of the thalamus for localization-related epilepsy. Methods: Participants were adults with medically refractory partial seizures, including secondarily generalized seizures. Half received stimulation and half no stimulation during a 3-month blinded phase; then all received unblinded stimulation. Results: One hundred ten participants were randomized. Baseline monthly median seizure frequency was 19.5. In the last month of the blinded phase the stimulated group had a 29% greater reduction in seizures compared with the control group, as estimated by a generalized estimating equations (GEE) model (p = 0.002). Unadjusted median declines at the end of the blinded phase were 14.5% in the control group and 40.4% in the stimulated group. Complex partial and “most severe” seizures were significantly reduced by stimulation. By 2 years, there was a 56% median percent reduction in seizure frequency; 54% of patients had a seizure reduction of at least 50%, and 14 patients were seizure-free for at least 6 months. Five deaths occurred and none were from implantation or stimulation. No participant had symptomatic hemorrhage or brain infection. Two participants had acute, transient stimulation-associated seizures. Cognition and mood showed no group differences, but participants in the stimulated group were more likely to report depression or memory problems as adverse events. Discussion: Bilateral stimulation of the anterior nuclei of the thalamus reduces seizures. Benefit persisted for 2 years of study. Complication rates were modest. Deep brain stimulation of the anterior thalamus is useful for some people with medically refractory partial and secondarily generalized seizures. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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