Evidence map›Paper›PMID 38002683›Full record

ArticleJournal of clinical medicine2023

MR-Guided Focused Ultrasound for Refractory Epilepsy: Where Are We Now?

Angelo Labate, Salvatore Bertino, Rosa Morabito, Chiara Smorto, Annalisa Militi, Simona Cammaroto, Carmelo Anfuso, Francesco Tomaiuolo, Paolo Tonin, Silvia Marino and 2 more

Open access · goldAbstract read
In one paragraph

Article in Journal of clinical medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.7field-weighted citation impact, top 28% 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

1 citing paper in PubMed, 6 citations in OpenAlex.

  1. Review
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

12 authors at 3 institutions in 1 country.

Angelo LabateNeurophysiopathology and Movement Disorders Unit, BIOMORF Department, University of Messina, 98124 Messina, Italy.
Salvatore BertinoDepartment of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy.
Rosa MorabitoIRCCS Centro Neurolesi "Bonino Pulejo", 98124 Messina, Italy.
Chiara SmortoIRCCS Centro Neurolesi "Bonino Pulejo", 98124 Messina, Italy.
Annalisa MilitiIRCCS Centro Neurolesi "Bonino Pulejo", 98124 Messina, Italy.
Simona CammarotoIRCCS Centro Neurolesi "Bonino Pulejo", 98124 Messina, Italy.
Carmelo AnfusoIRCCS Centro Neurolesi "Bonino Pulejo", 98124 Messina, Italy.
Francesco TomaiuoloDepartment of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy.
Paolo ToninS.Anna Institute, 88900 Crotone, Italy.ORCID 0000-0002-4867-1378
Silvia MarinoIRCCS Centro Neurolesi "Bonino Pulejo", 98124 Messina, Italy.
Antonio CerasaS.Anna Institute, 88900 Crotone, Italy.
Angelo QuartaroneIRCCS Centro Neurolesi "Bonino Pulejo", 98124 Messina, Italy.
Centro Neurolesi Bonino Pulejo · ITUniversity of Messina · ITIstituto S.Anna Crotone · IT

Funding

Ministry of Health Current Research 2023
6 · The paper itself

Abstract

Epilepsy is one of the most common neurological diseases in both adults and children. Despite improvements in medical care, 20 to 30% of patients are still resistant to the best medical treatment. The quality of life, neurologic morbidity, and even mortality of patients are significantly impacted by medically intractable epilepsy. Nowadays, conservative therapeutic approaches consist of increasing medication dosage, changing to a different anti-seizure drug as monotherapy, and combining different antiseizure drugs using an add-on strategy. However, such measures may not be sufficient to efficiently control seizure recurrence. Resective surgery, ablative procedures and non-resective neuromodulatory (deep-brain stimulation, vagus nerve stimulation) treatments are the available treatments for these kinds of patients. However, invasive procedures may involve lengthy inpatient stays for the patients, risks of long-term neurological impairment, general anesthesia, and other possible surgery-related complications (i.e., hemorrhage or infection). In the last few years, MR-guided focused ultrasound (MRgFUS) has been proposed as an emerging treatment for neurological diseases because of technological advancements and the goal of minimally invasive neurosurgery. By outlining the current knowledge obtained from both preclinical and clinical studies and discussing the technical opportunities of this therapy for particular epileptic phenotypes, in this perspective review, we explore the various mechanisms and potential applications (thermoablation, blood-brain barrier opening for drug delivery, neuromodulation) of high- and low-intensity ultrasound, highlighting possible novel strategies to treat drug-resistant epileptic patients who are not eligible or do not accept currently established surgical approaches. Taken together, the available studies support a possible role for lesional treatment over the anterior thalamus with high-intensity ultrasound and neuromodulation of the hippocampus via low-intensity ultrasound in refractory epilepsy. However, more studies, likely conceiving epilepsy as a network disorder and bridging together different scales and modalities, are required to make ultrasound delivery strategies meaningful, effective, and safe.

Indexed as

ablationintractable epilepsylow-frequency modulationMRgFUS

Identifiers

PMID38002683
PMCPMC10672423
OpenAlexW4388639330

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.