REVIEW article
Front. Neurol.
Sec. Epilepsy
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1608715
The role of the thalamus in Focal Human Epilepsy: insights from StereoElectroEncephalography (SEEG)
Provisionally accepted
- 1Service d'épileptologie et de neurophysiologie clinique, Hôpital de la Timone, Marseille, Provence-Alpes-Côte d'Azur, France
- 2INSERM U1106 Institut de Neurosciences des Systèmes, Faculté de Médecine, Aix Marseille Université, Marseille, Provence-Alpes-Côte d'Azur, France
- 3UMR7339 Centre de Résonance Magnétique Biologique et Médicale (CRMBM), Marseille, Provence-Alpes-Côte d'Azur, France
- 4Service de Neurochirurgie Fonctionnelle et Stéréotaxique, Hôpital de la Timone, Marseille, Provence-Alpes-Côte d'Azur, France
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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 eWectively reduced seizure frequency and improved consciousness during seizures. However, the eWectiveness 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, oWering 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
Keywords: refractory epilepsy, Thalamic epileptogenicity, stereotactic techniques, Thalamic Nuclei, subcortical areas
Received: 09 Apr 2025; Accepted: 19 May 2025.
Copyright: © 2025 Feys, Pizzo, Makhalova, Carron and Bartolomei. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Odile Feys, Service d'épileptologie et de neurophysiologie clinique, Hôpital de la Timone, Marseille, 13005, Provence-Alpes-Côte d'Azur, France
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