A meta-analysis on potential modifiers of LITT efficacy for mesial temporal lobe epilepsy: Seizure-freedom seems to fade with time.

Clinical Neurology and Neurosurgery
Alexandros G BrotisKonstantinos N Fountas

Abstract

The efficacy of laser interstitial thermal therapy (LITT) in mesial temporal lobe epilepsy (MTLE) has not been clearly established yet. We conducted a meta-analysis to estimate the efficacy of LITT for TLE (Q1). We also examined the effect of the patient's age (Q2), the total ablation volume (TAV) (Q3), the strength of the MRI unit (Q4), the type of the utilized stereotactic platform (Q5), and the follow up period (Q6) on the patient's outcome. Fixed- and random-effects model meta-analysis was conducted to assess the proportion estimate for each parameter individually. Kaplan-Meier survival-analysis was performed on the available individual patient time-to-first seizure data. Sixteen studies with 575 patients fulfilled our eligibility criteria. The efficacy of LITT was 0.547 (95%CI: 0.506-0.588). Our statistical analysis had robust results after stratification according to the study population (Q2; p = 0.3418), and the type of the utilized stereotactic platform (Q5; p = 0.286), whereas the role of the TAV (Q3; p = 0.058) and strength of the magnetic field (Q4; p = 0.062) in seizure control remained unclear. The median seizure-free period (Q6) was 0.643 (0.569-0.726) and 0.467 (0.385-0.566) for the one- and the two-year follow u...Continue Reading

References

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