The brain connectome as a personalized biomarker of seizure outcomes after temporal lobectomy. Neurology 2015 May 05;84(18):1846-53
Date
04/10/2015Pubmed ID
25854868Pubmed Central ID
PMC4433467DOI
10.1212/WNL.0000000000001548Scopus ID
2-s2.0-84928910818 (requires institutional sign-in at Scopus site) 106 CitationsAbstract
OBJECTIVE: We examined whether individual neuronal architecture obtained from the brain connectome can be used to estimate the surgical success of anterior temporal lobectomy (ATL) in patients with temporal lobe epilepsy (TLE).
METHODS: We retrospectively studied 35 consecutive patients with TLE who underwent ATL. The structural brain connectome was reconstructed from all patients using presurgical diffusion MRI. Network links in patients were standardized as Z scores based on connectomes reconstructed from healthy controls. The topography of abnormalities in linkwise elements of the connectome was assessed on subnetworks linking ipsilateral temporal with extratemporal regions. Predictive models were constructed based on the individual prevalence of linkwise Z scores >2 and based on presurgical clinical data.
RESULTS: Patients were more likely to achieve postsurgical seizure freedom if they exhibited fewer abnormalities within a subnetwork composed of the ipsilateral hippocampus, amygdala, thalamus, superior frontal region, lateral temporal gyri, insula, orbitofrontal cortex, cingulate, and lateral occipital gyrus. Seizure-free surgical outcome was predicted by neural architecture alone with 90% specificity (83% accuracy), and by neural architecture combined with clinical data with 94% specificity (88% accuracy).
CONCLUSIONS: Individual variations in connectome topography, combined with presurgical clinical data, may be used as biomarkers to better estimate surgical outcomes in patients with TLE.
Author List
Bonilha L, Jensen JH, Baker N, Breedlove J, Nesland T, Lin JJ, Drane DL, Saindane AM, Binder JR, Kuzniecky RIAuthor
Jeffrey R. Binder MD Professor in the Neurology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAnterior Temporal Lobectomy
Brain
Cohort Studies
Connectome
Diffusion Magnetic Resonance Imaging
Epilepsy, Temporal Lobe
Female
Humans
Male
Middle Aged
Neural Pathways
Retrospective Studies
Treatment Outcome
