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Resective epilepsy surgery in tuberous sclerosis complex: a nationwide multicentre retrospective study from China

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收录情况： ◇ SCIE

作者：
Shiyong Liu[1] ; Tao Yu[2] ; Yuguang Guan[3] ; Kai Zhang[4] ; Ping Ding[5] ; Lei Chen[6] ; Yongzhi Shan[7] ; Qiang Guo[8] ; Qingzhu Liu[9] ; Yi Yao[10] ; Meihua Yang[1] ; Shaohui Zhang[5] ; Yuanxiang Lin[11] ; Rui Zhao[12] ; Zhiqi Mao[13] ; Juncheng Zhang[14] ; Chunqing Zhang[1] ; Rui Zhang[15] ; Zhiquan Yang[16] ; Ruobing Qian[17] ; Yunlin Li[18] ; Guangming Zhang[19] ; Liu Yuan[5] ; Weidong Yang[20] ; Hong Tian[21] ; Hua Zhang[22] ; Wenling Li[23] ; Xinwei Zhang[24] ; Jian Yin[25] ; Yanwu Guo[26] ; Liping Zou[27] ; Jiong Qin[28] ; Fang Fang[29] ; Xu Wang[29] ; Ming Ge[30] ; Shuli Liang[31,*1] ;
机构： [1]Department of Neurosurgery, Xinqiao Hospital, Army Military Medical University, Chongqing, China [2]Department of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China [3]Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing, China [4]Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China [5]Department of Neurosurgery, Fourth Medical Center of PLA General Hospital, Beijing, China [6]Department of Neurology, Western China Hospital, Sichuan University, Chengdu, China [7]Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China [8]Department of Neurosurgery, Guangdong Sanjiu Brain Hospital, Guangzhou, China [9]Pediatric Epilepsy Surgery Center, First Affiliated Hospital of Peking University, Beijing, China [10]Department of Neurosurgery, Xiamen Hongai Hospital, Xiamen, China [11]Department of Neurosurgery, First Affiliated Hospital, Fujian Medical University, Fuzhou, China [12]Department of Neurosurgery, Children Hospital, Fudan University, Shanghai, China [13]Department of Neurosurgery, First Medical Center of PLA General Hospital, Beijing, China [14]Department of Neurosurgery, Affiliated Hospital of Jining Medical College, Jining, China [15]Department of Functional Neurosurgery, Brain Hospital, Nanjing Medical University, Nanjing, China [16]Department of Neurosurgery, Xiangya Hospital, Central Southern University, Changsha, China [17]Department of Neurosurgery, First Affiliated Hospital, University of Science and Technology of China, Hefei, China [18]Department of Neurosurgery, Children Hospital, Capital Institute of Pediatrics, Beijing, China [19]Department of Neurosurgery, Beijing Aviation General Hospital, Beijing, China [20]Department of Neurosurgery, General Hospital, Tianjin Medical University, Tianjin, China [21]Department of Neurosurgery, China-Japan Friendship Hospital, Beijing, China [22]Department of Neurosurgery, First Affiliated Hospital, Xi’an Jiaotong University, Xi’an, China [23]Department of Neurosurgery, Second Affiliated Hospital, Hebei Medical University, Shijiazhuang, China [24]Department of Neurosurgery, Third Affiliated Hospital, Southern Medical University, Guangzhou, China [25]Department of Neurosurgery, Second Affiliated Hospital, Dalian Medical University, Dalian, China [26]Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, Guangzhou, China [27]Pediatrics Department, First Medical Center of PLA General Hospital, Beijing, China [28]Pediatrics Department, Beijing People’s Hospital, Peking University, Beijing, China [29]Neurology Department, Beijing Children’s Hospital, Capital Medical University, Beijing, China [30]Neurosurgery Department, Beijing Children’s Hospital, Capital Medical University, Beijing, China [31]Functional Neurosurgery Department, Beijing Children’s Hospital, Capital Medical University, Beijing, China
出处：
DOI： 10.1093/brain/awz411
ISSN：

关键词： epilepsy surgery multicentre study quality of life resective surgery tuberous sclerosis complex

摘要：
At least 50% of patients with tuberous sclerosis complex present with intractable epilepsy; for these patients, resective surgery is a treatment option. Here, we report a nationwide multicentre retrospective study and analyse the long-term seizure and neuropsychological outcomes of epilepsy surgery in patients with tuberous sderosis complex. There were 364 patients who underwent epilepsy surgery in the study. Patients' clinical data, postoperative seizure outcomes at 1-, 4-, and 10-year follow-ups, preoperative and postoperative intelligence quotients, and quality of life at 1-year follow-up were collected. The patients' ages at surgery were 10.35 +/- 7.70 years (range: 0.5-47). The percentage of postoperative seizure freedom was 71% (258/364) at 1-year, 60% (118/196) at 4-year, and 51% (36/71) at 10-year follow-up. Influence factors of postoperative seizure freedom were the total removal of epileptogenic tubers and the presence of outstanding tuber on MRI at 1- and 4-year follow-ups. Furthermore, monthly seizure (versus daily seizure) was also a positive influence factor for postoperative seizure freedom at 1-year follow-up. The presence of an outstanding tuber on MRI was the only factor influencing seizure freedom at 10-year follow-up. Postoperative quality of life and intelligence quotient improvements were found in 43% (112/262) and 28% (67/242) of patients, respectively. Influence factors of postoperative quality of life and intelligence quotient improvement were postoperative seizure freedom and preoperative low intelligence quotient. The percentage of seizure freedom in the tuberectomy group was significantly lower compared to the tuberectomy plus and lobectomy groups at 1- and 4-year follow-ups. In conclusion, this study, the largest nationwide multicentre study on resective epilepsy surgery, resulted in improved seizure outcomes and quality of life and intelligence quotient improvements in patients with tuberous sclerosis complex. Seizure freedom was often achieved in patients with an outstanding tuber on MRI, total removal of epileptogenic tubers, and tuberectomy plus. Quality of life and intelligence quotient improvements were frequently observed in patients with postoperative seizure freedom and preoperative low intelligence quotient.

基金：
This research was supported by the Chinese National Nature & Science Foundation (81771388, 81271437, 81771394, 81771395), Brain Research Fund of Beijing Municipal Science and Technology Commission of China (Z171100000117014), Chinese Capital Health Development Research Project (2018-2-2096), and Beijing Nature & Science Foundation of China (L182055).
语种：
外文
被引次数：
WOS：
PubmedID：
中科院(CAS)分区：
出版当年[2020]版：
大类 | 1 区 医学
小类 | 1 区 临床神经病学 1 区 神经科学
最新[2023]版：
大类 | 1 区 医学
小类 | 1 区 临床神经病学 1 区 神经科学
JCR分区：
出版当年[2020]版：
Q1 CLINICAL NEUROLOGY Q1 NEUROSCIENCES
最新[2023]版：
Q1 CLINICAL NEUROLOGY Q1 NEUROSCIENCES

影响因子： 最新[2023版] 最新五年平均 出版当年[2020版] 出版当年五年平均 出版前一年[2019版] 出版后一年[2021版]

第一作者：
第一作者机构： [1]Department of Neurosurgery, Xinqiao Hospital, Army Military Medical University, Chongqing, China
共同第一作者：
通讯作者：
通讯机构： [31]Functional Neurosurgery Department, Beijing Children’s Hospital, Capital Medical University, Beijing, China [*1]Functional Neurosurgery Department, Beijing Children’s Hospital, Capital Medical University, Beijing, China
推荐引用方式(GB/T 7714)：
Shiyong Liu,Tao Yu,Yuguang Guan,et al.Resective epilepsy surgery in tuberous sclerosis complex: a nationwide multicentre retrospective study from China[J].BRAIN.2020,143:570-581.doi:10.1093/brain/awz411.
APA：
Shiyong Liu,Tao Yu,Yuguang Guan,Kai Zhang,Ping Ding...&Shuli Liang.(2020).Resective epilepsy surgery in tuberous sclerosis complex: a nationwide multicentre retrospective study from China.BRAIN,143,
MLA：
Shiyong Liu,et al."Resective epilepsy surgery in tuberous sclerosis complex: a nationwide multicentre retrospective study from China".BRAIN 143.(2020):570-581

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