The role of the thalamus in focal human epilepsy: insights from stereoelectroencephalography (SEEG)
This review explores the role of the thalamus in focal epilepsy, focusing on insights gained from stereoelectroencephalography (SEEG). The thalamus has recently regained attention as a crucial player in seizure dynamics. Thalamic SEEG recordings can be used to assess certain aspects of the thalamus’...
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Frontiers Media S.A.
2025-06-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2025.1608715/full |
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| author | Odile Feys Francesca Pizzo Francesca Pizzo Julia Makhalova Julia Makhalova Julia Makhalova Romain Carron Romain Carron Fabrice Bartolomei Fabrice Bartolomei |
| author_facet | Odile Feys Francesca Pizzo Francesca Pizzo Julia Makhalova Julia Makhalova Julia Makhalova Romain Carron Romain Carron Fabrice Bartolomei Fabrice Bartolomei |
| author_sort | Odile Feys |
| collection | DOAJ |
| description | This review explores the role of the thalamus in focal epilepsy, focusing on insights gained from stereoelectroencephalography (SEEG). The thalamus has recently regained attention as a crucial player in seizure dynamics. Thalamic SEEG recordings can be used to assess certain aspects of the thalamus’s role in human focal epilepsy, in particular the timing and dynamics of involvement of distinct thalamic nuclei during seizures and in interictal activity. Estimation of thalamic involvement in seizure propagation may be valuable before embarking on surgical resection and provide guidance for neuromodulation strategies. High thalamic epileptogenicity correlates with poorer surgical outcomes, making it a predictive biomarker. Deep brain stimulation (DBS), particularly targeting the anterior and pulvinar nuclei, has effectively reduced seizure frequency and improved consciousness during seizures. However, the effectiveness of DBS varies, emphasizing the need for individual targeting based on individual seizure dynamics. High-frequency thalamic stimulation can reduce seizure frequency and alter epileptogenic networks, offering tailored therapeutic approaches. Despite the potential added surgical risks of depth electrode implantation, thalamic SEEG significantly enhances the understanding of epileptogenic networks. It supports the development of personalized epilepsy treatments by elucidating the complex interplay between cortical and subcortical regions, paving the way for improved seizure management and neuromodulation strategies. |
| format | Article |
| id | doaj-art-76348cac9079403983f4dabbe36a5aaf |
| institution | OA Journals |
| issn | 1664-2295 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Neurology |
| spelling | doaj-art-76348cac9079403983f4dabbe36a5aaf2025-08-20T02:01:33ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-06-011610.3389/fneur.2025.16087151608715The role of the thalamus in focal human epilepsy: insights from stereoelectroencephalography (SEEG)Odile Feys0Francesca Pizzo1Francesca Pizzo2Julia Makhalova3Julia Makhalova4Julia Makhalova5Romain Carron6Romain Carron7Fabrice Bartolomei8Fabrice Bartolomei9APHM, Timone Hospital, Epileptology and Cerebral Rhythmology, Marseille, FranceAPHM, Timone Hospital, Epileptology and Cerebral Rhythmology, Marseille, FranceAix-Marseille Université, INSERM, INS, Institut de Neurosciences des Systèmes, Marseille, FranceAPHM, Timone Hospital, Epileptology and Cerebral Rhythmology, Marseille, FranceAix-Marseille Université, INSERM, INS, Institut de Neurosciences des Systèmes, Marseille, FranceAix-Marseille University, CNRS, CRMBM, Marseille, FranceAix-Marseille Université, INSERM, INS, Institut de Neurosciences des Systèmes, Marseille, FranceTimone Hospital, Medico-Surgical Unit Epileptology, Functional and Stereotactic Neurosurgery, Marseille, FranceAPHM, Timone Hospital, Epileptology and Cerebral Rhythmology, Marseille, FranceAix-Marseille Université, INSERM, INS, Institut de Neurosciences des Systèmes, Marseille, FranceThis review explores the role of the thalamus in focal epilepsy, focusing on insights gained from stereoelectroencephalography (SEEG). The thalamus has recently regained attention as a crucial player in seizure dynamics. Thalamic SEEG recordings can be used to assess certain aspects of the thalamus’s role in human focal epilepsy, in particular the timing and dynamics of involvement of distinct thalamic nuclei during seizures and in interictal activity. Estimation of thalamic involvement in seizure propagation may be valuable before embarking on surgical resection and provide guidance for neuromodulation strategies. High thalamic epileptogenicity correlates with poorer surgical outcomes, making it a predictive biomarker. Deep brain stimulation (DBS), particularly targeting the anterior and pulvinar nuclei, has effectively reduced seizure frequency and improved consciousness during seizures. However, the effectiveness of DBS varies, emphasizing the need for individual targeting based on individual seizure dynamics. High-frequency thalamic stimulation can reduce seizure frequency and alter epileptogenic networks, offering tailored therapeutic approaches. Despite the potential added surgical risks of depth electrode implantation, thalamic SEEG significantly enhances the understanding of epileptogenic networks. It supports the development of personalized epilepsy treatments by elucidating the complex interplay between cortical and subcortical regions, paving the way for improved seizure management and neuromodulation strategies.https://www.frontiersin.org/articles/10.3389/fneur.2025.1608715/fullrefractory epilepsythalamic epileptogenicitystereotactic techniquesthalamic nucleisubcortical areas |
| spellingShingle | Odile Feys Francesca Pizzo Francesca Pizzo Julia Makhalova Julia Makhalova Julia Makhalova Romain Carron Romain Carron Fabrice Bartolomei Fabrice Bartolomei The role of the thalamus in focal human epilepsy: insights from stereoelectroencephalography (SEEG) Frontiers in Neurology refractory epilepsy thalamic epileptogenicity stereotactic techniques thalamic nuclei subcortical areas |
| title | The role of the thalamus in focal human epilepsy: insights from stereoelectroencephalography (SEEG) |
| title_full | The role of the thalamus in focal human epilepsy: insights from stereoelectroencephalography (SEEG) |
| title_fullStr | The role of the thalamus in focal human epilepsy: insights from stereoelectroencephalography (SEEG) |
| title_full_unstemmed | The role of the thalamus in focal human epilepsy: insights from stereoelectroencephalography (SEEG) |
| title_short | The role of the thalamus in focal human epilepsy: insights from stereoelectroencephalography (SEEG) |
| title_sort | role of the thalamus in focal human epilepsy insights from stereoelectroencephalography seeg |
| topic | refractory epilepsy thalamic epileptogenicity stereotactic techniques thalamic nuclei subcortical areas |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2025.1608715/full |
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