MRI-guided laser interstitial thermal therapy in epilepsy: indications, technique and outcome in an adult population. A single-center data analysis

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  • dc.contributor.author Infante-Santos, Nazaret
  • dc.contributor.author Conesa Bertrán, Gerardo
  • dc.contributor.author Pérez Enríquez, Carmen
  • dc.contributor.author Capellades Font, Jaume
  • dc.contributor.author Panadés de Oliveira, Luísa
  • dc.contributor.author Vilella, Laura
  • dc.contributor.author Principe, Alessandro
  • dc.contributor.author Crespi-Vallespir, Maria Del Mar
  • dc.contributor.author Gallardo-Mir, Mireia
  • dc.contributor.author Rocamora Zúñiga, Rodrigo Alberto
  • dc.date.accessioned 2025-09-19T07:38:49Z
  • dc.date.available 2025-09-19T07:38:49Z
  • dc.date.issued 2025
  • dc.description.abstract Background: Magnetic Resonance Imaging guided Laser Interstitial Thermal Therapy (MRIgLITT) is a promising treatment for drug-resistant epilepsy (DRE) and an alternative to open surgery. However, the relationship between clinical and radiological factors and postoperative outcomes is unclear. This study explores the indications, technical challenges, and outcomes of MRIgLITT in terms of seizure control and cognitive changes across various pathologies. Methods: A retrospective single-center analysis included 32 MRIgLITT procedures performed between January 2019 and December 2023. Procedures used the Visualase® system for laser ablation, with stereotactic robotic guidance for fiber placement. Data included demographics, clinical and surgical details (ablated volume, timing, power and accuracy), and postoperative follow-up assessed seizure outcomes and complications. Cognitive changes were analyzed using a Reliable Change Index (RCI) before and one year after the procedure. Results: The 32 procedures involved 28 patients with MRI-diagnosed pathologies: 14 hippocampal sclerosis (HS), 7 hypothalamic hamartoma (HH), 3 focal cortical dysplasia (FCD), 2 periventricular heterotopia (PVH), 1 tuberous sclerosis complex (TSC), and 1 low-grade glioma. Some cases required multiple approaches. Postoperative follow-up averaged 33 months. Among HS patients, 71.42% achieved Engel I, and 21.43% Engel II. In HH, 85.7% initially became gelastic seizure-free, with complete freedom after additional treatment. Engel I outcomes were 28.6%, while 57.2% showed significant improvement (Engel I + II). FCD patients had a 66.6% Engel I success rate. One PVH patient became seizure-free, while the TSC patient was Engel III at last follow-up. RCI analysis showed that 71.44% of patients experienced cognitive stability (RCI > -1.64) or improvement (RCI > 1.64) at one-year post-procedure. Conclusions: MRIgLITT is a safe, minimally invasive alternative for epilepsy surgery, offering quicker recovery and showing better performance preserving cognitive function. It is particularly effective for deep or complex epileptic foci and patients who might refuse open surgery.
  • dc.format.mimetype application/pdf
  • dc.identifier.citation Infante N, Conesa G, Pérez-Enríquez C, Capellades J, de Oliveira LP, Vilella L, et al. MRI-guided laser interstitial thermal therapy in epilepsy: indications, technique and outcome in an adult population. A single-center data analysis. Acta Neurochir (Wien). 2025 Feb 8;167(1):39. DOI: 10.1007/s00701-025-06429-3
  • dc.identifier.doi http://dx.doi.org/10.1007/s00701-025-06429-3
  • dc.identifier.issn 0001-6268
  • dc.identifier.uri http://hdl.handle.net/10230/71235
  • dc.language.iso eng
  • dc.publisher Springer
  • dc.relation.ispartof Acta Neurochir (Wien). 2025 Feb 8;167(1):39
  • dc.rights © The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
  • dc.rights.accessRights info:eu-repo/semantics/openAccess
  • dc.rights.uri http://creativecommons.org/licenses/by/4.0/
  • dc.subject.keyword Cognition
  • dc.subject.keyword Drug-resistant epilepsy
  • dc.subject.keyword Laser ablation
  • dc.subject.keyword MRgLITT
  • dc.subject.keyword Minimally invasive surgery
  • dc.title MRI-guided laser interstitial thermal therapy in epilepsy: indications, technique and outcome in an adult population. A single-center data analysis
  • dc.type info:eu-repo/semantics/article
  • dc.type.version info:eu-repo/semantics/publishedVersion

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Articles (Hospital del Mar Research Institute)
Articles (Departament de Medicina i Ciències de la Vida)