New insights from MRI-guided laser interstitial thermal therapy for refractory epilepsy: a state-of-the-art overview
Introduction: Recently, MRI-guided laser interstitial thermal therapy (MRgLITT) has emerged as a therapeutic option for drug-resistant epilepsy (DRE). However, the absence of standardized clinical guidelines remains a significant issue. Objective: To conduct a systematic review of systematic reviews...
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| Formato: | Artículo de revisión |
| Lenguaje: | inglés |
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2026
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| author | Carlos Quispe-Vicuña Fernando Terry Miguel Cabanillas‐Lazo Alejandro Enríquez-Marulanda Niels Pacheco-Barrios Forough Yazdanian Jean Pierre Zila-Velasque David R. Soriano‐Moreno Cristian Morán‐Mariños Evan Luther Lekhaj Chand Daggubati Martín Andrés Merenzon Jaime Lopez-Calle Jorge G. Burneo Ricardo J. Komotar Ziev B. Moses John David Rolston Carlos Alva-Diaz |
| author_browse | Alejandro Enríquez-Marulanda Carlos Alva-Diaz Carlos Quispe-Vicuña Cristian Morán‐Mariños David R. Soriano‐Moreno Evan Luther Fernando Terry Forough Yazdanian Jaime Lopez-Calle Jean Pierre Zila-Velasque John David Rolston Jorge G. Burneo Lekhaj Chand Daggubati Martín Andrés Merenzon Miguel Cabanillas‐Lazo Niels Pacheco-Barrios Ricardo J. Komotar Ziev B. Moses |
| author_facet | Carlos Quispe-Vicuña Fernando Terry Miguel Cabanillas‐Lazo Alejandro Enríquez-Marulanda Niels Pacheco-Barrios Forough Yazdanian Jean Pierre Zila-Velasque David R. Soriano‐Moreno Cristian Morán‐Mariños Evan Luther Lekhaj Chand Daggubati Martín Andrés Merenzon Jaime Lopez-Calle Jorge G. Burneo Ricardo J. Komotar Ziev B. Moses John David Rolston Carlos Alva-Diaz |
| author_sort | Carlos Quispe-Vicuña |
| collection | Producción científica |
| description | Introduction: Recently, MRI-guided laser interstitial thermal therapy (MRgLITT) has emerged as a therapeutic option for drug-resistant epilepsy (DRE). However, the absence of standardized clinical guidelines remains a significant issue. Objective: To conduct a systematic review of systematic reviews to provide a descriptive assessment of the quality of evidence regarding the application of MRgLITT for DRE. Methods: We conducted a comprehensive search in PubMed, Embase, Scopus, Web of Science, Cochrane Library, and Google Scholar up to May 30th, 2024. We evaluated the risk of bias in each study using the AMSTAR-2 tool. The primary outcomes assessed were seizure freedom and perioperative or postoperative complications rate, while the secondary outcome was reoperation rate. The certainty of the evidence was appraised using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach. Finally, pertinent findings were illustrated in a bubble plot. Results: A total of 16 systematic reviews met eligibility criteria, just including observational studies (cohorts and case series). Fourteen SRs scored "Critically low" with a median 8 [IQR: 5.25-8.25]. Seizure freedom rate ranged from 18.87% to 75.86%, and the most frequent cause of DRE was mesial temporal lobe epilepsy. The most common complications were visual field deficit (2.17%-7.5%) and intracranial hemorrhage (0.96%-8.6%). All the outcomes reported a "very low" certainty of evidence, as randomized studies were absent in the reviews. Conclusion: This overview provides comprehensive evidence on the application of MRgLITT for DRE). The evidence indicates a seizure freedom rate ranging from 18.87% to 75.86% with certainty levels raning from critically low to low. While these findings are promising, further primary and secondary studies are essential to establish definitive conclusions and assess the potential for future clinical applications or recommendations. Protocol Registration Number: CRD42022339024. |
| format | Review |
| id | openalex:W7162782329 |
| institution | UPeU |
| language | English |
| publishDate | 2026 |
| publishDateRange | 2026 |
| publishDateSort | 2026 |
| record_format | dspace |
| spelling | openalex:W7162782329New insights from MRI-guided laser interstitial thermal therapy for refractory epilepsy: a state-of-the-art overviewCarlos Quispe-VicuñaFernando TerryMiguel Cabanillas‐LazoAlejandro Enríquez-MarulandaNiels Pacheco-BarriosForough YazdanianJean Pierre Zila-VelasqueDavid R. Soriano‐MorenoCristian Morán‐MariñosEvan LutherLekhaj Chand DaggubatiMartín Andrés MerenzonJaime Lopez-CalleJorge G. BurneoRicardo J. KomotarZiev B. MosesJohn David RolstonCarlos Alva-Diazdrug-resistant epilepsyseizure freedompostoperative complicationsvisual field defectsintracranial hemorrhagereoperation ratemesial temporal lobe epilepsyquality of evidenceEpilepsy research and treatmentDeep Brain Stimulation and Movement DisordersUltrasound and Hyperthermia ApplicationsIntroduction: Recently, MRI-guided laser interstitial thermal therapy (MRgLITT) has emerged as a therapeutic option for drug-resistant epilepsy (DRE). However, the absence of standardized clinical guidelines remains a significant issue. Objective: To conduct a systematic review of systematic reviews to provide a descriptive assessment of the quality of evidence regarding the application of MRgLITT for DRE. Methods: We conducted a comprehensive search in PubMed, Embase, Scopus, Web of Science, Cochrane Library, and Google Scholar up to May 30th, 2024. We evaluated the risk of bias in each study using the AMSTAR-2 tool. The primary outcomes assessed were seizure freedom and perioperative or postoperative complications rate, while the secondary outcome was reoperation rate. The certainty of the evidence was appraised using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach. Finally, pertinent findings were illustrated in a bubble plot. Results: A total of 16 systematic reviews met eligibility criteria, just including observational studies (cohorts and case series). Fourteen SRs scored "Critically low" with a median 8 [IQR: 5.25-8.25]. Seizure freedom rate ranged from 18.87% to 75.86%, and the most frequent cause of DRE was mesial temporal lobe epilepsy. The most common complications were visual field deficit (2.17%-7.5%) and intracranial hemorrhage (0.96%-8.6%). All the outcomes reported a "very low" certainty of evidence, as randomized studies were absent in the reviews. Conclusion: This overview provides comprehensive evidence on the application of MRgLITT for DRE). The evidence indicates a seizure freedom rate ranging from 18.87% to 75.86% with certainty levels raning from critically low to low. While these findings are promising, further primary and secondary studies are essential to establish definitive conclusions and assess the potential for future clinical applications or recommendations. Protocol Registration Number: CRD42022339024.Reviewhttps://doi.org/10.3389/fsurg.2026.1642054https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2026.1642054/pdfW7162782329enFrontiers in Surgery2296-875X2026-05-29 |
| spellingShingle | drug-resistant epilepsy seizure freedom postoperative complications visual field defects intracranial hemorrhage reoperation rate mesial temporal lobe epilepsy quality of evidence Epilepsy research and treatment Deep Brain Stimulation and Movement Disorders Ultrasound and Hyperthermia Applications Carlos Quispe-Vicuña Fernando Terry Miguel Cabanillas‐Lazo Alejandro Enríquez-Marulanda Niels Pacheco-Barrios Forough Yazdanian Jean Pierre Zila-Velasque David R. Soriano‐Moreno Cristian Morán‐Mariños Evan Luther Lekhaj Chand Daggubati Martín Andrés Merenzon Jaime Lopez-Calle Jorge G. Burneo Ricardo J. Komotar Ziev B. Moses John David Rolston Carlos Alva-Diaz New insights from MRI-guided laser interstitial thermal therapy for refractory epilepsy: a state-of-the-art overview |
| title | New insights from MRI-guided laser interstitial thermal therapy for refractory epilepsy: a state-of-the-art overview |
| title_full | New insights from MRI-guided laser interstitial thermal therapy for refractory epilepsy: a state-of-the-art overview |
| title_fullStr | New insights from MRI-guided laser interstitial thermal therapy for refractory epilepsy: a state-of-the-art overview |
| title_full_unstemmed | New insights from MRI-guided laser interstitial thermal therapy for refractory epilepsy: a state-of-the-art overview |
| title_short | New insights from MRI-guided laser interstitial thermal therapy for refractory epilepsy: a state-of-the-art overview |
| title_sort | new insights from mri guided laser interstitial thermal therapy for refractory epilepsy a state of the art overview |
| topic | drug-resistant epilepsy seizure freedom postoperative complications visual field defects intracranial hemorrhage reoperation rate mesial temporal lobe epilepsy quality of evidence Epilepsy research and treatment Deep Brain Stimulation and Movement Disorders Ultrasound and Hyperthermia Applications |
| topic_facet | drug-resistant epilepsy seizure freedom postoperative complications visual field defects intracranial hemorrhage reoperation rate mesial temporal lobe epilepsy quality of evidence Epilepsy research and treatment Deep Brain Stimulation and Movement Disorders Ultrasound and Hyperthermia Applications |
| url | https://doi.org/10.3389/fsurg.2026.1642054 https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2026.1642054/pdf |
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