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The surgical approach to the anterior nucleus of thalamus in patients with refractory epilepsy : experience from the international multicenter registry (MORE)

(2019) NEUROSURGERY. 84(1). p.141-149
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Abstract
BACKGROUND: The Medtronic Registry for Epilepsy (MORE; Medtronic Inc, Dublin, Ireland) is an open label observational study evaluating the long-term effectiveness, safety, and performance of deep brain stimulation (DBS) of the anterior nucleus of thalamus (ANT) for the treatment of refractory epilepsy. OBJECTIVE: To compare the difference in success rate of placing contacts at ANT-target region (ANT-TR) between transventricular (TV) and extraventricular (EV) lead trajectories in 73 ANT-DBS implants in 17 European centers participating in the MORE registry. METHODS: The success rate of placing contacts at ANT-TR was evaluated using a screening method combining both individual patient imaging information and stereotactic atlas information to identify contacts at ANT-TR. RESULTS: EV lead trajectory was used in 53% of the trajectories. Approximately, 90% of the TV lead trajectories had at least 1 contact at ANT-TR, vs only 71% of the EV lead trajectories. The success rate for placing at least 1 contact at ANT-TR bilaterally was 84% for TV implants and 58% for EV implants (P <.05; Fisher's exact). No intracranial bleedings were observed, but 1 cortical infarct was reported following EV lead trajectory. CONCLUSION: The results of this registry support the use of TV lead trajectories for ANT-DBS as they have a higher probability in placing contacts at ANT-TR, without appearing to compromise procedural safety. Follow-up data collection is continuing in the MORE registry. These data will provide outcomes associated with TV and EV trajectories.
Keywords
Epilepsy, Deep brain stimulation, Anterior nucleus of thalamus, Trajectory, DEEP BRAIN-STIMULATION, ELECTRICAL-STIMULATION, INTRACTABLE EPILEPSY, TARGET

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Chicago
Lehtimäki, Kai, Volker A Coenen, Antonio Gonçalves Ferreira, Paul Boon, Christian Elger, Rod S Taylor, Philippe Ryvlin, et al. 2019. “The Surgical Approach to the Anterior Nucleus of Thalamus in Patients with Refractory Epilepsy : Experience from the International Multicenter Registry (MORE).” Neurosurgery 84 (1): 141–149.
APA
Lehtimäki, K., Coenen, V. A., Gonçalves Ferreira, A., Boon, P., Elger, C., Taylor, R. S., Ryvlin, P., et al. (2019). The surgical approach to the anterior nucleus of thalamus in patients with refractory epilepsy : experience from the international multicenter registry (MORE). NEUROSURGERY, 84(1), 141–149.
Vancouver
1.
Lehtimäki K, Coenen VA, Gonçalves Ferreira A, Boon P, Elger C, Taylor RS, et al. The surgical approach to the anterior nucleus of thalamus in patients with refractory epilepsy : experience from the international multicenter registry (MORE). NEUROSURGERY. 2019;84(1):141–9.
MLA
Lehtimäki, Kai et al. “The Surgical Approach to the Anterior Nucleus of Thalamus in Patients with Refractory Epilepsy : Experience from the International Multicenter Registry (MORE).” NEUROSURGERY 84.1 (2019): 141–149. Print.
@article{8582765,
  abstract     = {BACKGROUND: The Medtronic Registry for Epilepsy (MORE; Medtronic Inc, Dublin, Ireland) is an open label observational study evaluating the long-term effectiveness, safety, and performance of deep brain stimulation (DBS) of the anterior nucleus of thalamus (ANT) for the treatment of refractory epilepsy. 
OBJECTIVE: To compare the difference in success rate of placing contacts at ANT-target region (ANT-TR) between transventricular (TV) and extraventricular (EV) lead trajectories in 73 ANT-DBS implants in 17 European centers participating in the MORE registry. 
METHODS: The success rate of placing contacts at ANT-TR was evaluated using a screening method combining both individual patient imaging information and stereotactic atlas information to identify contacts at ANT-TR. 
RESULTS: EV lead trajectory was used in 53\% of the trajectories. Approximately, 90\% of the TV lead trajectories had at least 1 contact at ANT-TR, vs only 71\% of the EV lead trajectories. The success rate for placing at least 1 contact at ANT-TR bilaterally was 84\% for TV implants and 58\% for EV implants (P {\textlangle}.05; Fisher's exact). No intracranial bleedings were observed, but 1 cortical infarct was reported following EV lead trajectory. 
CONCLUSION: The results of this registry support the use of TV lead trajectories for ANT-DBS as they have a higher probability in placing contacts at ANT-TR, without appearing to compromise procedural safety. Follow-up data collection is continuing in the MORE registry. These data will provide outcomes associated with TV and EV trajectories.},
  author       = {Lehtim{\"a}ki, Kai and Coenen, Volker A and Gon\c{c}alves Ferreira, Antonio and Boon, Paul and Elger, Christian and Taylor, Rod S and Ryvlin, Philippe and Gil-Nagel, Antonio and Gielen, Frans and Brionne, Thomas C and Abouihia, Abdallah and Beth, Gr{\'e}gory},
  issn         = {0148-396X},
  journal      = {NEUROSURGERY},
  language     = {eng},
  number       = {1},
  pages        = {141--149},
  title        = {The surgical approach to the anterior nucleus of thalamus in patients with refractory epilepsy : experience from the international multicenter registry (MORE)},
  url          = {http://dx.doi.org/10.1093/neuros/nyy023},
  volume       = {84},
  year         = {2019},
}

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