Epilepsy affects about 1% of the world’s population, and up to 30% of all patients will ultimately not achieve freedom from seizures with anticonvulsive medication alone. While surgical resection of a magnetic resonance imaging (MRI) -identifiable lesion remains the first-line treatment option for drug-refractory epilepsy, surgery cannot be offered to all. Neuromodulatory therapy targeting “seizures” instead of “epilepsy” has emerged as a valuable treatment option for these patients, including invasive procedures such as deep brain stimulation (DBS), responsive neurostimulation (RNS) and peripheral approaches such as vagus nerve stimulation (VNS). The purpose of this review is to provide in-depth information on current concepts and evidence on network-level aspects of drug-refractory epilepsy. We reviewed the current evidence gained from studies utilizing advanced imaging methodology, with a specific focus on their contributions to neuromodulatory therapy.

中文翻译：

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影像学对药物难治性癫痫神经调节治疗的贡献


癫痫症影响着世界上约 1% 的人口，而高达 30% 的患者最终无法仅靠抗惊厥药物摆脱癫痫发作。虽然手术切除磁共振成像（MRI）可识别的病变仍然是药物难治性癫痫的一线治疗选择，但手术不能向所有人提供。针对“癫痫发作”而不是“癫痫”的神经调节疗法已成为这些患者的一种有价值的治疗选择，包括深部脑刺激（DBS）、反应性神经刺激（RNS）等侵入性手术以及迷走神经刺激（VNS）等外周方法。本综述的目的是提供有关药物难治性癫痫网络层面的当前概念和证据的深入信息。我们回顾了从利用先进成像方法的研究中获得的当前证据，特别关注它们对神经调节治疗的贡献。