For drug-resistant epileptics, surgery is often the only way to stop
Staff at University College Londonstudied the frontal lobes of patients who had previously undergone frontal lobe resection from 2007 to 2021. After analyzing MRI scans of 47 people, the researchers found that the absence of seizures in the long term was associated with the shutdown of neural pathways linking the frontal lobe with the thalamus and striatum of the brain.
The thalamus is an egg-shaped structure inin the middle of the brain, a relay station for all incoming motor and sensory information. It is also responsible for wakefulness and is linked to the brain's limbic system, which processes and regulates emotions, forms and stores memories, and is involved in learning. The striatum is a collection of structures—the caudate nucleus, putamen, and nucleus accumbens—best known for facilitating voluntary movement, but also plays a role in the brain's reward system.
Researchers found that patients whowho had this particular nerve pathway cut, 88% were seizure-free at three years and 80% at five years, compared with typical frontal lobe resection outcomes. Importantly, the surgery did not negatively impact the patients' language or executive function — a set of mental skills that includes working memory, flexible thinking and self-control.
These findings go a long way toward explaining why resection works for some and not for others, the researchers say. The study is published in the journal Brain.
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