Focused ultrasound for treatment of epilepsy: a systematic review and meta-analysis of preclinical and clinical studies.

IF 2.5 3区 医学 Q2 CLINICAL NEUROLOGY
Alireza Soltani Khaboushan, Rasa Zafari, Mohammadmahdi Sabahi, MirHojjat Khorasanizadeh, Mohammad Amin Dabbagh Ohadi, Oliver Flouty, Manish Ranjan, Konstantin V Slavin
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Abstract

Various preclinical and clinical studies have demonstrated the neuromodulatory and ablative effects of focused ultrasound (FUS). However, the safety and efficacy of FUS in clinical settings for treating epilepsy have not been well established. This study aims to provide a systematic review of all preclinical and clinical studies that have used FUS for the treatment of epilepsy. A systematic search was conducted using Scopus, Web of Science, PubMed, and Embase databases. All preclinical and clinical studies reporting outcomes of FUS in the treatment of epilepsy were included in the systematic review. Random-effect meta-analysis was performed to determine safety in clinical studies and seizure activity reduction in preclinical studies. A total of 24 articles were included in the study. Meta-analysis demonstrated that adverse events occurred in 13% (95% CI = 2-57%) of patients with epilepsy who underwent FUS. The frequency of adverse events was higher with the use of FUS for lesioning (36%, 95% CI = 4-88%) in comparison to neuromodulation (5%, 95% CI = 0-71%), although this difference was not significant (P = 0.31). Three-level meta-analysis in preclinical studies demonstrated a reduced spike rate in neuromodulating FUS compared to the control group (P = 0.02). According to this systematic review and meta-analysis, FUS can be considered a safe and feasible approach for treating epileptic seizures, especially in drug-resistant patients. While the efficacy of FUS has been demonstrated in several preclinical studies, further research is necessary to confirm its effectiveness in clinical practice and to determine the adverse events.

聚焦超声治疗癫痫:临床前和临床研究的系统回顾和荟萃分析。
各种临床前和临床研究已经证明了聚焦超声(FUS)的神经调节和消融作用。然而,FUS 在临床环境中治疗癫痫的安全性和有效性尚未得到很好的证实。本研究旨在对使用 FUS 治疗癫痫的所有临床前和临床研究进行系统回顾。我们使用 Scopus、Web of Science、PubMed 和 Embase 数据库进行了系统性检索。所有报告 FUS 治疗癫痫结果的临床前和临床研究均被纳入系统综述。随机效应荟萃分析用于确定临床研究的安全性和临床前研究中癫痫发作活动减少的情况。研究共纳入了 24 篇文章。荟萃分析表明,在接受FUS治疗的癫痫患者中,13%(95% CI = 2-57%)的患者发生了不良事件。与神经调控(5%,95% CI = 0-71%)相比,使用 FUS 进行病变治疗的不良事件发生率更高(36%,95% CI = 4-88%),但这一差异并不显著(P = 0.31)。临床前研究的三级荟萃分析表明,与对照组相比,神经调控 FUS 的尖峰率降低(P = 0.02)。根据这项系统综述和荟萃分析,可以认为 FUS 是治疗癫痫发作的一种安全可行的方法,尤其适用于耐药患者。虽然 FUS 的疗效已在多项临床前研究中得到证实,但仍有必要开展进一步研究,以确认其在临床实践中的有效性,并确定其不良反应。
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
Neurosurgical Review
Neurosurgical Review 医学-临床神经学
CiteScore
5.60
自引率
7.10%
发文量
191
审稿时长
6-12 weeks
期刊介绍: The goal of Neurosurgical Review is to provide a forum for comprehensive reviews on current issues in neurosurgery. Each issue contains up to three reviews, reflecting all important aspects of one topic (a disease or a surgical approach). Comments by a panel of experts within the same issue complete the topic. By providing comprehensive coverage of one topic per issue, Neurosurgical Review combines the topicality of professional journals with the indepth treatment of a monograph. Original papers of high quality are also welcome.
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