Comparison of the real-world effectiveness of vertical versus lateral functional hemispherotomy techniques for pediatric drug-resistant epilepsy: A post hoc analysis of the HOPS study

被引：29

作者：

Fallah, Aria ^{[1
]}

Lewis, Evan ^{[2
]}

Ibrahim, George M. ^{[3
]}

Kola, Olivia ^{[1
]}

Tseng, Chi-Hong ^{[4
]}

Harris, William B. ^{[5
]}

Chen, Jia-Shu ^{[6
]}

Lin, Kao-Min ^{[7
]}

Cai, Li-Xin ^{[8
]}

Liu, Qing-Zhu ^{[8
]}

Lin, Jiu-Luan ^{[9
]}

Zhou, Wen-Jing ^{[9
]}

Mathern, Gary W. ^{[1
]}

Smyth, Matthew D. ^{[10
]}

O'Neill, Brent R. ^{[11
]}

Dudley, Roy W. R. ^{[12
]}

Ragheb, John ^{[13
]}

Bhatia, Sanjiv ^{[13
]}

Delev, Daniel ^{[14
,15
]}

Ramantani, Georgia ^{[14
,15
,16
]}

Zentner, Josef ^{[14
,15
]}

Wang, Anthony C. ^{[1
]}

Dorfer, Christian ^{[17
]}

Feucht, Martha ^{[18
]}

Czech, Thomas ^{[17
]}

Bollo, Robert J. ^{[19
]}

Issabekov, Galymzhan ^{[20
]}

Zhu, Hongwei ^{[20
]}

Connolly, Mary ^{[21
,22
]}

Steinbok, Paul ^{[21
,22
]}

Zhang, Jian-Guo ^{[23
]}

Zhang, Kai ^{[23
]}

Hidalgo, Eveline Teresa ^{[24
]}

Weiner, Howard L. ^{[25
]}

Wong-Kisiel, Lily ^{[26
]}

Lapalme-Remis, Samuel ^{[27
]}

Tripathi, Manjari ^{[28
]}

Chandra, Poodipedi Sarat ^{[29
,30
]}

Hader, Walter ^{[31
]}

Wang, Feng-Peng ^{[7
]}

Yao, Yi ^{[32
]}

Champagne, Pierre-Olivier ^{[33
]}

Brunette-Clement, Tristan ^{[33
]}

Guo, Qiang ^{[34
]}

Li, Shao-Chun ^{[34
]}

Budke, Marcelo ^{[35
]}

Perez-Jimenez, Maria Angeles ^{[36
]}

Raftopoulos, Christian ^{[37
]}

Finet, Patrice ^{[37
]}

Michel, Pauline ^{[37
]}

机构：

[1] Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurosurg, Los Angeles, CA 90095 USA

[2] Neurol Ctr Toronto, Toronto, ON, Canada

[3] Univ Toronto, Hosp Sick Children, Div Neurosurg, Toronto, ON, Canada

[4] Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA 90095 USA

[5] Univ Hawaii, John A Burns Sch Med, Dept Med, Honolulu, HI 96822 USA

[6] Brown Univ, Dept Med, Warren Alpert Med Sch, Providence, RI 02912 USA

[7] Xiamen Humanity Hosp, Dept Funct Neurosurg, Xiamen, Peoples R China

[8] Peking Univ First Hosp, Dept Pediat Epilepsy Ctr, Beijing, Peoples R China

[9] Tsinghua Univ, Yuquan Hosp, Dept Epilepsy Ctr, Beijing, Peoples R China

[10] St Louis Childrens Hosp, Dept Neurol Surg, St Louis, MO 63178 USA

[11] Childrens Hosp Colorado, Dept Neurosurg, Aurora, CO USA

[12] McGill Univ Hlth Ctr, Montreal Childrens Hosp, Dept Pediat Surg, Div Neurosurg, Montreal, PQ, Canada

[13] Nicklaus Childrens Hosp, Dept Neurosurg, Miami, FL USA

[14] Univ Freiburg, Univ Med Ctr Freiburg, Dept Neurosurg, Freiburg, Germany

[15] Univ Freiburg, Med Fac, Freiburg, Germany

[16] Univ Childrens Hosp Zurich, Dept Neuropediat, Zurich, Switzerland

[17] Med Univ Vienna, Dept Neurosurg, Vienna, Austria

[18] Med Univ Vienna, Dept Pediat, Vienna, Austria

[19] Primary Childrens Med Ctr, Dept Neurosurg, Div Pediat Neurosurg, Salt Lake City, UT USA

[20] Capital Med Univ, Xuanwu Hosp, Beijing Inst Funct Neurosurg, Dept Funct Neurosurg, Beijing, Peoples R China

[21] BC Childrens Hosp, Dept Surg, Div Neurosurg, Vancouver, BC, Canada

[22] Univ British Columbia, Vancouver, BC, Canada

[23] Capital Med Univ, Beijing Tiantan Hosp, Dept Neurosurg, Beijing, Peoples R China

[24] NYU Langone Hlth, Hassenfeld Childrens Hosp, Dept Surg, Div Pediat Neurosurg, New York, NY USA

[25] Texas Childrens Hosp, Baylor Coll Med, Houston, TX 77030 USA

[26] Mayo Clin, Coll Med, Div Child Neurol & Epilepsy, Rochester, MN USA

[27] Univ Montreal Hosp Ctr, Dept Med, Div Neurol, Montreal, PQ, Canada

[28] All India Inst Med Sci, Dept Neurosurg, New Delhi, India

[29] All India Inst Med Sci, Dept Neurosurg, Ctr Excellence Epilepsy & Mapetoencephalogaphy, New Delhi, India

[30] Natl Brain Res Ctr, New Delhi, India

[31] Univ Calgary, Dept Clin Neurosci, Div Neurosurg, Calgary, AB, Canada

[32] Guangdong Shenzhen Children Hosp, Dept Neurosurg, Shenzhen, Peoples R China

[33] St Justine Univ Hosp Ctr, Dept Neurosurg, Montreal, PQ, Canada

[34] Guangdong Sanjiu Brain Hosp, Dept Neurosurg, Guangzhou Shi, Peoples R China

[35] Nino Jesus Univ Childrens Hosp, Dept Neurosurg, Madrid, Spain

[36] Nino Jesus Univ Childrens Hosp, Dept Neurophysiol, Madrid, Spain

[37] Brussels St Luc Univ Hosp, Dept Neurosurg, Brussels, Belgium

[38] Geneva Univ Hosp, Dept Clin Neurosci, Div Neurosurg, Geneva, Switzerland

[39] Univ Zurich, Univ Hosp Zurich, Dept Neurosurg, Zurich, Switzerland

[40] Univ Zurich, Clin Neurosci Ctr, Zurich, Switzerland

[41] Univ Padua, Acad Neurosurg, Dept Neurosci, Padua, Italy

[42] Pontificia Univ Catolica Chile, Sotero del Rio Hosp, Dept Neurosurg, Santiago, Chile

[43] Neurol Neurophysiol Epilepsy Serv Fdn Childhood N, Epilepsy Dept, Buenos Aires, DF, Argentina

[44] Brandenburg Med Sch, Dept Neurosurg, Neuruppin, Germany

[45] Childrens Natl Med Ctr, Dept Neurosurg, Washington, DC 20010 USA

[46] Childrens Natl Med Ctr, Div Child Neurol & Epilepsy, Washington, DC 20010 USA

[47] Childrens Natl Med Ctr, Div Neurophysiol, Washington, DC 20010 USA

[48] Alfaisal Univ, King Faisal Specialist Hosp & Res Ctr, Dept Neurosci, Riyadh, Saudi Arabia

[49] Boston Childrens Hosp, Dept Neurol, Boston, MA USA

来源：

EPILEPSIA | 2021年 / 62卷 / 11期

基金：

美国国家科学基金会; 美国国家卫生研究院;

关键词：

hemispherectomy; hemispherotomy; seizure outcomes; technique; PERI-INSULAR HEMISPHEROTOMY; FAILED HEMISPHEROTOMY; INTRACTABLE EPILEPSY; REFRACTORY EPILEPSY; CHILDHOOD EPILEPSY; HEMISPHERECTOMY; OUTCOMES; SURGERY; PREDICTORS; COMPLICATIONS;

D O I：

10.1111/epi.17021

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Objective This study was undertaken to determine whether the vertical parasagittal approach or the lateral peri-insular/peri-Sylvian approach to hemispheric surgery is the superior technique in achieving long-term seizure freedom. Methods We conducted a post hoc subgroup analysis of the HOPS (Hemispheric Surgery Outcome Prediction Scale) study, an international, multicenter, retrospective cohort study that identified predictors of seizure freedom through logistic regression modeling. Only patients undergoing vertical parasagittal, lateral peri-insular/peri-Sylvian, or lateral trans-Sylvian hemispherotomy were included in this post hoc analysis. Differences in seizure freedom rates were assessed using a time-to-event method and calculated using the Kaplan-Meier survival method. Results Data for 672 participants across 23 centers were collected on the specific hemispherotomy approach. Of these, 72 (10.7%) underwent vertical parasagittal hemispherotomy and 600 (89.3%) underwent lateral peri-insular/peri-Sylvian or trans-Sylvian hemispherotomy. Seizure freedom was obtained in 62.4% (95% confidence interval [CI] = 53.5%-70.2%) of the entire cohort at 10-year follow-up. Seizure freedom was 88.8% (95% CI = 78.9%-94.3%) at 1-year follow-up and persisted at 85.5% (95% CI = 74.7%-92.0%) across 5- and 10-year follow-up in the vertical subgroup. In contrast, seizure freedom decreased from 89.2% (95% CI = 86.3%-91.5%) at 1-year to 72.1% (95% CI = 66.9%-76.7%) at 5-year to 57.2% (95% CI = 46.6%-66.4%) at 10-year follow-up for the lateral subgroup. Log-rank test found that vertical hemispherotomy was associated with durable seizure-free progression compared to the lateral approach (p = .01). Patients undergoing the lateral hemispherotomy technique had a shorter time-to-seizure recurrence (hazard ratio = 2.56, 95% CI = 1.08-6.04, p = .03) and increased seizure recurrence odds (odds ratio = 3.67, 95% CI = 1.05-12.86, p = .04) compared to those undergoing the vertical hemispherotomy technique. Significance This pilot study demonstrated more durable seizure freedom of the vertical technique compared to lateral hemispherotomy techniques. Further studies, such as prospective expertise-based observational studies or a randomized clinical trial, are required to determine whether a vertical approach to hemispheric surgery provides superior long-term seizure outcomes.

引用

页码：2707 / 2718

页数：12

共 47 条

[41] Presurgical evaluation of pediatric epilepsy patients prior to hemispherotomy: the prognostic value of 18F-FDG PET [J].

Traub-Weidinger, Tatjana ;

Weidinger, Philip ;

Groppel, Gundrun ;

Karanikas, Georgios ;

Wadsak, Wolfgang ;

Kasprian, Gregor ;

Dorfer, Christian ;

Dressler, Anastasia ;

Muehlebner, Angelika ;

Hacker, Marcus ;

Czech, Thomas ;

Feucht, Martha .

JOURNAL OF NEUROSURGERY-PEDIATRICS, 2016, 18 (06) :683-688

[42]

van Buuren S, 2011, J STAT SOFTW, V45, P1

[43] Peri-insular hemispherotomy in paediatric epilepsy [J].

Villemure, Jean-Guy ;

Daniel, Roy Thomas .

CHILDS NERVOUS SYSTEM, 2006, 22 (08) :967-981

[44] PERI-INSULAR HEMISPHEROTOMY - SURGICAL PRINCIPLES AND ANATOMY [J].

VILLEMURE, JG ;

MASCOTT, CR .

NEUROSURGERY, 1995, 37 (05) :975-981

[45] Hemispherectomy Outcome Prediction Scale: Development and validation of a seizure freedom prediction tool [J].

Weil, Alexander G. ;

Lewis, Evan C. ;

Ibrahim, George M. ;

Kola, Olivia ;

Tseng, Chi-Hong ;

Zhou, Xinkai ;

Lin, Kao-Min ;

Cai, Li-Xin ;

Liu, Qing-Zhu ;

Lin, Jiu-Luan ;

Zhou, Wen-Jing ;

Mathern, Gary W. ;

Smyth, Matthew D. ;

O'Neill, Brent R. ;

Dudley, Roy ;

Ragheb, John ;

Bhatia, Sanjiv ;

Delev, Daniel ;

Ramantani, Georgia ;

Zentner, Josef ;

Ojemann, Jeffrey ;

Wang, Anthony C. ;

Dorfer, Christian ;

Feucht, Martha ;

Czech, Thomas ;

Bollo, Robert J. ;

Issabekov, Galymzhan ;

Zhu, Hongwei ;

Connelly, Mary ;

Steinbok, Paul ;

Zhang, Jian-Guo ;

Zhang, Kai ;

Hidalgo, Eveline Teresa ;

Weiner, Howard L. ;

Wong-Kisiel, Lily ;

Lapalme-Remis, Samuel ;

Tripathi, Manjari ;

Sarat Chandra, Poodipedi ;

Hader, Walter ;

Wang, Feng-Peng ;

Yao, Yi ;

Olivier Champagne, Pierre ;

Guo, Qiang ;

Li, Shao-Chun ;

Budke, Marcelo ;

Perez-Jimenez, Maria Angeles ;

Raftapoulos, Christian ;

Finet, Patrice ;

Michel, Pauline ;

Schaller, Karl .

EPILEPSIA, 2021, 62 (05) :1064-1073

[46] Functional hemispherectomy: can preoperative imaging predict outcome? [J].

Weil, Alexander G. ;

Fallah, Aria ;

Wang, Shelly ;

Ibrahim, George M. ;

Elkaim, Lior M. ;

Jayakar, Prasanna ;

Miller, Ian ;

Bhatia, Sanjiv ;

Niazi, Toba N. ;

Ragheb, John .

JOURNAL OF NEUROSURGERY-PEDIATRICS, 2020, 25 (06) :567-573

[47] Medically resistant pediatric insular-opercular/perisylvian epilepsy. Part 1: invasive monitoring using the parasagittal transinsular apex depth electrode [J].

Weil, Alexander G. ;

Fallah, Aria ;

Lewis, Evan C. ;

Bhatia, Sanjiv .

JOURNAL OF NEUROSURGERY-PEDIATRICS, 2016, 18 (05) :511-522

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