Evidence map›Paper›PMID 37822361›Full record

ArticleTherapeutic advances in neurological disorders2023

Structural connections of the centromedian nucleus of thalamus and their relevance for neuromodulation in generalized drug-resistant epilepsy: insight from a tractography study.

Luigi G Remore, Ziad Rifi, Hiroki Nariai, Dawn S Eliashiv, Aria Fallah, Benjamin D Edmonds, Joyce H Matsumoto, Noriko Salamon, Meskerem Tolossa, Wexin Wei and 3 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Therapeutic advances in neurological disorders, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
4.5field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 22 citations in OpenAlex.

  1. Article
  2. Short-Term Modulation of Epileptic Network with Low-Frequency Thalamic Stimulation.medRxiv : the preprint server for health sciences · 2025
    Article
  3. Article
  4. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 2 institutions in 2 countries.

Luigi G RemoreSurgical Neuromodulation and Brain Mapping Laboratory, ULCA.ORCID https://orcid.org/0000-0003-4118-9009
Ziad RifiDepartment of Neurosurgery, University of California Los Angeles, Los Angeles, CA, USA.
Hiroki NariaiDivision of Pediatric Neurology, Department of Pediatrics, University of California Los Angeles, Los Angeles, CA, USA.
Dawn S EliashivDavid Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
Aria FallahDepartment of Neurosurgery, University of California Los Angeles, Los Angeles, CA, USA.
Benjamin D EdmondsDivision of Pediatric Neurology, Department of Pediatrics, University of California Los Angeles, Los Angeles, CA, USA.
Joyce H MatsumotoDivision of Pediatric Neurology, Department of Pediatrics, University of California Los Angeles, Los Angeles, CA, USA.
Noriko SalamonDavid Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
Meskerem TolossaDepartment of Neurosurgery, University of California Los Angeles, Los Angeles, CA, USA.
Wexin WeiDepartment of Neurosurgery, University of California Los Angeles, Los Angeles, CA, USA.
Marco LocatelliUniversity of Milan 'La Statale', Milan, Italy.
Evangelia C TsolakiDepartment of Neurosurgery, University of California Los Angeles, Los Angeles, CA, USA.
Ausaf A BariDepartment of Neurosurgery, University of California Los Angeles, Los Angeles, CA, USA.
University of California, Los Angeles · USUniversity of Milan · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Epilepsy is a widespread neurologic disorder and almost one-third of patients suffer from drug-resistant epilepsy (DRE). Neuromodulation targeting the centromediannucleus of the thalamus (CM) has been showing promising results for patients with generalized DRE who are not surgical candidates. Recently, the effect of CM- deep brain stimulation (DBS) in DRE patients was investigated in the Electrical Stimulation of Thalamus for Epilepsy of Lennox-Gastaut phenotype (ESTEL) trial, a monocentric randomized-controlled study. The same authors described a 'cold-spot' and a 'sweet-spot', which are defined as the volume of stimulation in the thalamus yielding the least and the best clinical response, respectively. However, it remains unclear which structural connections may contribute to the anti-seizure effect of the stimulation. Objective: We investigated the differences in structural connectivity among CM, the sweet-spot and the cold-spot. Furthermore, we tried to validate our results in a cohort of DRE patients who underwent CM-DBS or CM-RNS (responsive neurostimulation). We hypothesized that the sweet-spot would share similar structural connectivity with responder patients. Methods: By using the software FMRIB Software Library (FSL), probabilistic tractography was performed on 100 subjects from the Human Connectome Project to calculate the probability of connectivity of the whole CM, the sweet-spot and the cold-spot to 45 cortical and subcortical areas. Results among the three seeds were compared with multivariate analysis of variance (MANOVA). Similarly, the structural connectivity of volumes of tissue activated (VTAs) from eight DRE patients was investigated. Patients were divided into responders and non-responders based on the degree of reduction in seizure frequency, and the mean probabilities of connectivity were similarly compared between the two groups. Results: The sweet-spot demonstrated a significantly higher probability of connectivity ( Conclusion: Cerebellar connections seem to contribute to the beneficial effects of CM-neuromodulation in patients with drug-resistant generalized epilepsy.

Indexed as

centromedian nucleuscerebellumdeep brain stimulationepilepsyresponsive neurostimulation

Identifiers

PMID37822361
PMCPMC10563482
OpenAlexW4387478986

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.