Results from the tractography analysis confirmed those from the voxel-based and atlas-based analyses: at three years, patients with anterior thalamic disconnection showed a trend towards better seizure outcomes (11/17 patients were seizure free) with an average of 41% of streamlines resected in the seizure-free group versus 16% resected in those with seizure recurrence [ t (15) = 2.08; P < 0.056], which was significant if the five patients with partial resections were excluded [8/12 patients seizure free; 41% versus 10% streamlines resected in seizure-free/seizure-recurrence groups, t (10) = 2.44; P < 0.035].
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Thalamostriatal disconnection underpins long-term seizure freedom in frontal lobe epilepsy surgery.
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