The impact of resective epilepsy surgery on the brain network: evidence from post-surgical imaging

IF 11.7 1区医学 Q1 CLINICAL NEUROLOGY Brain Pub Date : 2025-01-24 DOI:10.1093/brain/awaf026

Lucas E Sainburg, Dario J Englot, Victoria L Morgan

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Abstract

Resective epilepsy surgery can be an effective treatment for patients with medication-resistant focal epilepsy. Epilepsy resection consists of the surgical removal of an epileptic focus to stop seizure generation and disrupt the epileptic network. However, even focal surgical resections for epilepsy lead to widespread brain network changes. Understanding the impact of epilepsy surgery on the brain is crucial to improve surgical outcomes for patients. Here we provide a summary of studies imaging the postsurgical effects of epilepsy resection on the brain. We focus on MRI and PET studies of temporal lobe and pediatric epilepsy, reflecting the current literature. We discuss three potential mechanisms for surgery-induced brain changes: damage and degeneration, recovery, and reorganization. We additionally review the postsurgical brain correlates of surgical outcomes as well as the potential to predict the impact of surgery on an individual patient’s brain. A comprehensive characterization of the impact of surgery on the brain and precise methods to predict these brain network changes could lead to more personalized surgeries that improve seizure outcomes and reduce neuropsychological deficits after surgery.

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切除性癫痫手术对脑网络的影响：来自术后影像学的证据

切除性癫痫手术是治疗顽固性局灶性癫痫的有效方法。癫痫切除术包括手术切除癫痫病灶，以阻止癫痫发作的产生和破坏癫痫网络。然而，即使局灶性手术切除癫痫也会导致广泛的脑网络改变。了解癫痫手术对大脑的影响对于改善患者的手术效果至关重要。在这里，我们提供了研究的总结成像癫痫切除术后对大脑的影响。我们集中于颞叶和小儿癫痫的MRI和PET研究，反映了目前的文献。我们讨论了三种可能的机制手术引起的大脑改变：损伤和变性，恢复和重组。我们还回顾了手术结果的术后脑相关性，以及预测手术对个体患者大脑影响的潜力。全面描述手术对大脑的影响以及精确预测这些大脑网络变化的方法，可能会导致更多个性化的手术，从而改善癫痫发作的结果，减少手术后的神经心理缺陷。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Brain 医学-临床神经学

CiteScore

20.30

自引率

4.10%

发文量

458

审稿时长

3-6 weeks

期刊介绍： Brain, a journal focused on clinical neurology and translational neuroscience, has been publishing landmark papers since 1878. The journal aims to expand its scope by including studies that shed light on disease mechanisms and conducting innovative clinical trials for brain disorders. With a wide range of topics covered, the Editorial Board represents the international readership and diverse coverage of the journal. Accepted articles are promptly posted online, typically within a few weeks of acceptance. As of 2022, Brain holds an impressive impact factor of 14.5, according to the Journal Citation Reports.