{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T05:48:47Z","timestamp":1788414527833,"version":"build-2803163510"},"reference-count":36,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2020,8,10]],"date-time":"2020-08-10T00:00:00Z","timestamp":1597017600000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["K02NS070960"],"award-info":[{"award-number":["K02NS070960"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["R01NS088748"],"award-info":[{"award-number":["R01NS088748"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Magnetic resonance imaging (MRI)\u2013guided laser interstitial thermal therapy (MRg\u2010LITT) is an alternative to open epilepsy surgery. We assess safety and effectiveness of MRg\u2010LITT for extratemporal lobe epilepsy (ETLE) in patients who are considered less favorable for open resection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively reviewed sequential cases of patients with focal ETLE who underwent MRg\u2010LITT between 2012 and 2019. Epileptogenic zones were determined from standard clinical and imaging data\u00a0\u00b1\u00a0stereoelectroencephalography (SEEG). Standard stereotactic techniques, MRI thermometry, and a commercial laser thermal therapy system were used for ablations. Anatomic MRI was used to calculate ablation volumes. Clinical outcomes were determined longitudinally.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010five patients with mean epilepsy duration of 21.3\u00a0\u00b1\u00a012.2\u00a0years underwent MRg\u2010LITT for focal ETLE at a mean age 36.4\u00a0\u00b1\u00a012.7\u00a0years. A mean 2.59\u00a0\u00b1\u00a01.45 trajectories per patient were used to obtain ablation volumes of 8.8\u00a0\u00b1\u00a07.5\u00a0cm<jats:sup>3<\/jats:sup>. Mean follow\u2010up was 27.3\u00a0\u00b1\u00a019.5\u00a0months. Of 32 patients with &gt;12\u00a0months of follow\u2010up, 17 (53%) achieved good outcomes (Engel class I\u00a0+\u00a0II) of whom 14 (44%) were Engel class I. Subgroup analysis revealed better outcomes for patients with lesional ETLE than for those who were nonlesional, multifocal, or who had failed prior interventions (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.02). Of 13 patients showing favorable seizure\u2010onset patterns (localized low voltage fast activity or rhythmic spiking on SEEG) prior to ablation, 9 (69%) achieved good outcomes, whereas only 3 of 11 (27%) who show other slower onset patterns achieved good outcomes. Minor adverse events included six patients with transient sensorimotor neurologic deficits and four patients with asymptomatic hemorrhages along the fiber tract. Major adverse events included one patient with a brain abscess that required stereotactic drainage and one patient with persistent hypothalamic obesity. Three deaths\u2014two seizure\u2010associated and one suicide\u2014were unrelated to surgical procedures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>MRI\u2010guided laser interstitial thermal therapy (or MRg\u2010LITT) was well\u2010tolerated and yielded good outcomes in a heterogeneous group of ETLE patients. Lesional epilepsy and favorable seizure\u2010onset patterns on SEEG predicted higher likelihoods of success.<\/jats:p><\/jats:sec>","DOI":"10.1111\/epi.16614","type":"journal-article","created":{"date-parts":[[2020,8,10]],"date-time":"2020-08-10T21:59:43Z","timestamp":1597096783000},"page":"1723-1734","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":55,"title":["Stereotactic MRI\u2010guided laser interstitial thermal therapy for extratemporal lobe epilepsy"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9847-0099","authenticated-orcid":false,"given":"Kunal","family":"Gupta","sequence":"first","affiliation":[{"name":"Department of Neurosurgery Emory University School of Medicine Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Cabaniss","sequence":"additional","affiliation":[{"name":"Department of Neurology Emory University School of 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