{
  "abstract": "Objective: Lennox–Gastaut syndrome (LGS) is generally regarded as a developmental and epileptic encephalopathy involving distributed brain networks, although a focal structural abnormality may occasionally recruit bilateral cortical and thalamic circuits and produce an LGS phenotype. We characterized the spatiotemporal organization of such a network and its changes after focal SEEG-guided radiofrequency thermocoagulation (RF-TC).\n\nMethods: A 50-year-old woman with drug-resistant epilepsy, multiple seizure types, diffuse slow spike-and-wave discharges, generalized paroxysmal fast activity, intellectual impairment, and right frontal periventricular heterotopia (PVH) underwent stereo-electroencephalography (SEEG). Cortico-cortical evoked potentials (CCEPs) were acquired before and after SEEG-guided radiofrequency thermocoagulation (RF-TC). Resting-state functional MRI (rs-fMRI), obtained before and 3 months after RF-TC, was analyzed using three seeds: the entire right frontal PVH and the right and left centromedian thalamic nuclei (CM).\n\nResults: SEEG identified the earliest sustained ictal activity within the sampled right frontal PVH-related medial contacts, accompanied by high-frequency activity. This was followed by ipsilateral lateral frontal recruitment, contralateral frontal synchronization, and subsequent bilateral CM involvement. Two-stage RF-TC of the onset and early-recruited networks was followed by seizure freedom through 9 months. After RF-TC, right-sided stimulation produced markedly attenuated lesion-related CCEP responses, whereas left-sided responses and responses between thalamic contacts showed little appreciable change. Descriptive rs-fMRI difference maps demonstrated decreased local frontal connectivity around the treated territory and increased long-range connectivity for the PVH seed; both CM seeds showed predominantly increased connectivity with distributed cortical and cerebellar regions.\n\nConclusion: In this patient, a focal PVH-related epileptogenic network was associated with secondary bilateral cortical and thalamic recruitment underlying an LGS phenotype. CCEP and rs-fMRI captured complementary aspects of postoperative network change: attenuation of stimulation-evoked propagation and postoperative changes in intrinsic functional connectivity, respectively.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Functional Neurosurgery, Comprehensive Epilepsy Unit, Ruijin Hospital Luwan Branch, Shanghai Jiao Tong University, School of Medicine , ,",
    "Department of Radiology, Ruijin Hospital Luwan Branch, Shanghai Jiao Tong University, School of Medicine , ,"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Changquan Wang"
    },
    {
      "affs": [
        0
      ],
      "name": "Jing Hong"
    },
    {
      "affs": [
        1
      ],
      "name": "Jialin Ji"
    },
    {
      "affs": [
        0
      ],
      "name": "Caicai Zhang"
    },
    {
      "affs": [
        0
      ],
      "name": "Wenzhen Chen"
    },
    {
      "affs": [
        0
      ],
      "name": "Jiwen Xu"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/9samgd2bfwbaa.bib",
  "cited_by": 0,
  "doi": "10.3389/fnins.2026.1961911",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661969/?tool=EBI",
  "id": "9samgd2bfwbaa",
  "issns": [
    "1662-4548",
    "1662-453X"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13661969",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2738|Epilepsy research and treatment"
    ]
  ],
  "openalex": "W7214996974",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661969/pdf/?tool=EBI",
  "pmcid": "PMC13661969",
  "pmid": null,
  "published": "2026-09-30",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/9samgd2bfwbaa.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:20Z",
      "native_id": "PMC:PMC13661969",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13661969"
    },
    {
      "first_seen": "2026-10-30T12:19:23Z",
      "native_id": "10.3389/fnins.2026.1961911",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fnins.2026.1961911/full"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2738|Epilepsy research and treatment",
      "subfield": "psychiatry"
    }
  ],
  "title": "Case Report: Right frontal periventricular heterotopia underlying secondary network epilepsy with a Lennox–Gastaut phenotype: multimodal SEEG, CCEP, and rs-fMRI evidence",
  "title_text": "Case Report: Right frontal periventricular heterotopia underlying secondary network epilepsy with a Lennox–Gastaut phenotype: multimodal SEEG, CCEP, and rs-fMRI evidence",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:23Z",
  "url": "https://research.draconitic.com/paper/9samgd2bfwbaa",
  "venue": "Frontiers in neuroscience",
  "versions": []
}