ArticleNeurologia medico-chirurgica2026
Thalamic Volume Asymmetry as a Potential Predictor of Vagus Nerve Stimulation Outcomes in Refractory Epilepsy.
Article in Neurologia medico-chirurgica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Vagus nerve stimulation is an established treatment for refractory epilepsy, but predictors of treatment response remain unclear. Given that left-sided vagus nerve stimulation preferentially modulates the left thalamus and that epileptic networks induce thalamic structural damage, we investigated whether preoperative thalamic volume asymmetry predicts vagus nerve stimulation outcomes. This retrospective study included 17 patients with refractory epilepsy who underwent vagus nerve stimulation implantation. Patients were classified as responders (≥50% seizure reduction at 24 months, n = 9) or non-responders (n = 8). Thalamic volumes were manually segmented on preoperative T2-weighted magnetic resonance imaging by 2 blinded raters, and we used the rater-averaged values to calculate the left/right volume ratio and asymmetry index. The mean thalamic volume ratio (left/right) was significantly higher in responders than non-responders (1.00 [95% confidence interval 0.97-1.03] vs 0.96 [95% confidence interval 0.92-0.99], p = 0.027), and the asymmetry index also differed between groups (0.00 [95% confidence interval -0.015 to 0.017] vs -0.023 [95% confidence interval -0.040 to -0.006], p = 0.027). Inter-rater reliability was acceptable for absolute volumes but was lower for ratio-based asymmetry indices, suggesting that these derived metrics may be more suitable for group-level comparisons than for single-patient prediction. Epileptogenic laterality determined by electroencephalography did not predict thalamic asymmetry. Relative left thalamic volume reduction was associated with poor vagus nerve stimulation treatment response. Assessment of preoperative thalamic asymmetry on routine structural magnetic resonance imaging may represent a candidate biomarker for predicting vagus nerve stimulation efficacy, pending validation in larger cohorts.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.