Middlebrooks Erik H, He Xiaosong, Grewal Sanjeet S, Keller Simon S
Department of Radiology, Mayo Clinic, Jacksonville, FL, USA; Department of Neurosurgery, Mayo Clinic, Jacksonville, FL, USA.
Department of Psychology, University of Science and Technology of China, Hefei, Anhui, China.
Epilepsy Res. 2022 May;182:106916. doi: 10.1016/j.eplepsyres.2022.106916. Epub 2022 Mar 30.
Neuromodulation is an increasingly utilized therapy for the treatment of people with drug-resistant epilepsy. To date, the most common and effective target has been the thalamus, which is known to play a key role in multiple forms of epilepsy. Neuroimaging has facilitated rapid developments in the understanding of functional targets, surgical and programming techniques, and the effects of thalamic stimulation. In this review, the role of neuroimaging in neuromodulation is explored. First, the structural and functional changes of the thalamus in common epilepsy syndromes are discussed as the rationale for neuromodulation of the thalamus. Next, methods for imaging different thalamic nuclei are presented, as well as rationale for the need of direct surgical targeting rather than reliance on traditional stereotactic coordinates. Lastly, we discuss the potential role of neuroimaging in assessing the effects of thalamic stimulation and as a potential biomarker for neuromodulation outcomes.
神经调节作为一种治疗耐药性癫痫患者的疗法，其应用越来越广泛。迄今为止，最常见且有效的靶点是丘脑，众所周知，丘脑在多种癫痫形式中起着关键作用。神经影像学促进了人们在功能靶点、手术和程控技术以及丘脑刺激效果等方面的快速发展。在这篇综述中，我们探讨了神经影像学在神经调节中的作用。首先，讨论了常见癫痫综合征中丘脑的结构和功能变化，作为丘脑神经调节的理论基础。其次，介绍了对不同丘脑核进行成像的方法，以及直接手术靶向而非依赖传统立体定向坐标的必要性。最后，我们讨论了神经影像学在评估丘脑刺激效果以及作为神经调节结果潜在生物标志物方面的潜在作用。
