丘脑中央中核脑深部电刺激治疗难治性癫痫进展

doi:10.19854/j.cnki.1008-2425.2022.02.0013

摘要/Abstract

摘要： 丘脑中央中核属于内髓板内核团,和感觉运动区和整个大脑有着密切的联系,在感觉运动、疼痛、注意力和觉醒等均有重要作用。丘脑中央中核作为难治性癫痫的治疗靶点已经有30余年时间。临床结果显示丘脑中央中核电刺激是一种安全的治疗方法,对全面性发作(全身强直阵挛发作、不典型失神、强直发作等)和Lennox-Gastaut综合征的效果好于复杂部分性发作,对难治性癫痫持续状态也有较好的作用,此外还能减少全脑广泛性放电和额叶局灶性放电,但对颞叶放电没有影响。目前需要大样本对照研究比较其与其他神经调控方法的异同。

关键词: 丘脑中央中核, 癫痫, 脑深部电刺激, 手术

中图分类号:

R742.1

刘强强综述, 徐纪文审校. 丘脑中央中核脑深部电刺激治疗难治性癫痫进展[J]. 立体定向和功能性神经外科杂志, 2022, 35(2): 125-128.

参考文献

[1] Devinsky O,Vezzani A,O'Brien TJ,et al.Epilepsy[J].Nature reviews.Disease primers,2018,4:18024.
[2] Chakravarty K,Ray S,Kharbanda P S,et al.Temporal lobe epilepsy with amygdala enlargement:A systematic review[J].Acta neurologica Scandinavica,2021,144(3):236~250.
[3] Velasco F,Velasco M,Ogarrio C,et al.Electrical stimulation of the centromedian thalamic nucleus in the treatment of convulsive seizures:a preliminary report[J].Epilepsia,1987,28(4):421~430.
[4] 潘琪,牛朝诗.丘脑中央中核-束旁核复合体的解剖生理研究[J].中华神经医学杂志,2006,5(8):859~861.
[5] Kim S H,Lim S C,Yang D W,et al.Thalamo-cortical network underlying deep brain stimulation of centromedian thalamic nuclei in intractable epilepsy:a multimodal imaging analysis[J].Neuropsychiatric disease and treatment,2017,13:2607~2619.
[6] Parent M,Parent A.Single-axon tracing and three-dimensional reconstruction of centre median-parafascicular thalamic neurons in primates[J].The Journal of comparative neurology,2005,481(1):127~144.
[7] Smith Y,Galvan A,Ellender TJ,et al.The thalamostriatal system in normal and diseased states[J].Frontiers in systems neuroscience,2014,8:5.
[8] Sadikot AF,Parent A,François C.The centremédian and parafascicular thalamic nuclei project respectively to the sensorimotor and associative-limbic striatal territories in the squirrel monkey[J].Brain research,1990,510(1):161~165.
[9] Sadikot AF,Parent A,Smith Y,et al.Efferent connections of the centromedian and parafascicular thalamic nuclei in the squirrel monkey:a light and electron microscopic study of the thalamostriatal projection in relation to striatal heterogeneity[J].The Journal of comparative neurology,1992,320(2):228~242.
[10] Ilyas A,Pizarro D,Romeo AK,et al.The centromedian nucleus:Anatomy,physiology,and clinical implications[J].Journal of clinical neuroscience,2019,63:1~7.
[11] Jang SH,Lim HW,Yeo SS.The neural connectivity of the intralaminar thalamic nuclei in the human brain:a diffusion tensor tractography study[J].Neuroscience letters,2014,579:140~144.
[12] Velasco F,Velasco M,Márquez I,et al.Role of the centromedian thalamic nucleus in the genesis,propagation and arrest of epileptic activity.An electrophysiological study in man[J].Acta neurochirurgica.Supplementum,1993,58:201~204.
[13] Vetkas A,Fomenko A,Germann J,et al.Deep brain stimulation targets in epilepsy:Systematic review and meta-analysis of anterior and centromedian thalamic nuclei and hippocampus[J].Epilepsia,2022,63(3):513~524.
[14] Khan M,Paktiawal J,Piper RJ,et al.Intracranial neuromodulation with deep brain stimulation and responsive neurostimulation in children with drug-resistant epilepsy:a systematic review[J].Journal of neurosurgery.Pediatrics,2021:1~10.
[15] Klinger N,Mittal S.Deep brain stimulation for seizure control in drug-resistant epilepsy[J].Neurosurgical focus,2018,45(2):E4.
[16] Velasco F,Velasco M,Jiménez F,et al.Predictors in the treatment of difficult-to-control seizures by electrical stimulation of the centromedian thalamic nucleus[J].Neurosurgery,2000,47(2):295~304.
[17] Velasco F,Velasco M,Jiménez F,et al.Centromedian nucleus stimulation for epilepsy Clinical,electroencephalographic,and behavioral observations[J].Thalamus & Related Systems,2002,1(4):387~398.
[18] Fisher RS,Uematsu S,Krauss GL,et al.Placebo-controlled pilot study of centromedian thalamic stimulation in treatment of intractable seizures[J].Epilepsia,1992,33(5):841~851.
[19] Valentín A,García Navarrete E,Chelvarajah R,et al.Deep brain stimulation of the centromedian thalamic nucleus for the treatment of generalized and frontal epilepsies[J].Epilepsia,2013,54(10):1823~1833.
[20] Son B-C,Shon YM,Choi J-G,et al.Clinical Outcome of Patients with Deep Brain Stimulation of the Centromedian Thalamic Nucleus for Refractory Epilepsy and Location of the Active Contacts[J].Stereotactic and functional neurosurgery,2016,94(3):187~197.
[21] Cukiert A,Burattini JA,Cukiert C M,et al.Centro-median stimulation yields additional seizure frequency and attention improvement in patients previously submitted to callosotomy[J].Seizure,2009,18(8):588~592.
[22] Cukiert A,Cukiert CM,Burattini JA,et al.Seizure outcome during bilateral,continuous,thalamic centromedian nuclei deep brain stimulation in patients with generalized epilepsy:a prospective,open-label study[J].Seizure,2020,81:304~309.
[23] Valentín A,Nguyen HQ,Skupenova AM,et al.Centromedian thalamic nuclei deep brain stimulation in refractory status epilepticus[J].Brain stimulation,2012,5(4):594~598.
[24] Lehtimäki K,LångsjöJ W,Ollikainen J,et al.Successful management of super-refractory status epilepticus with thalamic deep brain stimulation[J].Annals of neurology,2017,81(1):142~146.
[25] Hect JL,Fernandez LD,Welch WP,et al.Deep brain stimulation of the centromedian thalamic nucleus for the treatment of FIRES[J].Epilepsia open,2022,7(1):187~193.
[26] Sa M,Singh R,Pujar S,et al.Centromedian thalamic nuclei deep brain stimulation and Anakinra treatment for FIRES - Two different outcomes[J].European journal of paediatric neurology,2019,23(5):749~754.
[27] Stavropoulos I,Selway R,Hasegawa H,et al.Low frequency centromedian thalamic nuclei deep brain stimulation for the treatment of super refractory status epilepticus:A case report and a review of the literature[J].Brain stimulation,2021,14(2):226~229.
[28] Velasco M,Velasco F,Velasco AL,et al.Epileptiform EEG activities of the centromedian thalamic nuclei in patients with intractable partial motor,complex partial,and generalized seizures[J].Epilepsia,1989,30(3):295~306.
[29] Pasnicu A,Denoyer Y,Haegelen C,et al.Modulation of paroxysmal activity in focal cortical dysplasia by centromedian thalamic nucleus stimulation[J].Epilepsy research,2013,104(3):264~268.
[30] Chkhenkeli SA,Sramka M,Lortkipanidze GS,et al.Electrophysiological effects and clinical results of direct brain stimulation for intractable epilepsy[J].Clinical neurology and neurosurgery,2004,106(4):318~329.
[31] Aguado-Carrillo G,Velasco AL,Saucedo-Alvarado PE,et al.Radiofrequency ablation of the centromedian thalamic nucleus in the treatment of drug-resistant epilepsy[J].Epilepsy & behavior,2021,114(Pt A):107560.
[32] Warren AEL,Dalic LJ,Thevathasan W,et al.Targeting the centromedian thalamic nucleus for deep brain stimulation[J].Journal of neurology,neurosurgery,and psychiatry,2020,91(4):339~349.
[33] Li J,Li Y,Gutierrez L,et al.Imaging the centromedian thalamic nucleus using quantitative susceptibility mapping[J].Frontiers in human neuroscience,2019,13:447.
[34] Velasco AL,Velasco F,Jiménez F,et al.Neuromodulation of the centromedian thalamic nuclei in the treatment of generalized seizures and the improvement of the quality of life in patients with Lennox-Gastaut syndrome[J].Epilepsia,2006,47(7):1203~1212.
[35] Alcala-Zermeno JL,Gregg NM,Wirrell EC,et al.Centromedian thalamic nucleus with or without anterior thalamic nucleus deep brain stimulation for epilepsy in children and adults:A retrospective case series[J].Seizure,2021,84:101~107.