Failure of Standard Magnetic Resonance Imaging in Patients With Refractory Temporal Lobe Epilepsy

McBride, Margaret C.; Bronstein, Kathryn S.; Bennett, Barbara; Erba, Giuseppe; Pilcher, Webster H.; Berg, Michel J.

doi:10.1001/archneur.55.3.346

Cited by 58 publications

(34 citation statements)

References 8 publications

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“…10 With regard to the first factor, the ROC analyses indicated moderate to high accuracy for prediction of TLE laterality. As to the second, the machine learning approach may reduce the incidence of hippocampal sclerosis being missed at nonspecialized institutions 30,31 and may help predict postoperative seizure control in the future.…”

Section: Discussionmentioning

confidence: 99%

Machine Learning of DTI Structural Brain Connectomes for Lateralization of Temporal Lobe Epilepsy

Kamiya

Amemiya

Suzuki

et al. 2016

MRMS

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Background and Purpose: We analyzed the ability of a machine learning approach that uses diffusion tensor imaging (DTI) structural connectomes to determine lateralization of epileptogenicity in temporal lobe epilepsy (TLE).Materials and Methods: We analyzed diffusion tensor and 3-dimensional (3D) T 1 -weighted images of 44 patients with TLE (right, 15, left, 29; mean age, 33.0 « 11.6 years) and 14 age-matched controls. We constructed a whole brain structural connectome for each subject, calculated graph theoretical network measures, and used a support vector machine (SVM) for classification among 3 groups (right TLE versus controls, left TLE versus controls, and right TLE versus left TLE) following a feature reduction process with sparse linear regression.Results: In left TLE, we found a significant decrease in local efficiency and the clustering coefficient in several brain regions, including the left posterior cingulate gyrus, left cuneus, and both hippocampi. In right TLE, the right hippocampus showed reduced nodal degree, clustering coefficient, and local efficiency. With use of the leave-one-out crossvalidation strategy, the SVM classifier achieved accuracy of 75.9 to 89.7% for right TLE versus controls, 74.4 to 86.0% for left TLE versus controls, and 72.7 to 86.4% for left TLE versus right TLE.Conclusion: Machine learning of graph theoretical measures from the DTI structural connectome may give support to lateralization of the TLE focus. The present good discrimination between left and right TLE suggests that, with further refinement, the classifier should improve presurgical diagnostic confidence.

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Section: Discussionmentioning

confidence: 99%

Machine Learning of DTI Structural Brain Connectomes for Lateralization of Temporal Lobe Epilepsy

Kamiya

Amemiya

Suzuki

et al. 2016

MRMS

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“…Structural abnormalities were commonly (>70%) detected in such patients [18]if optimal MRI sequences were used [19, 20, 21]. In general, surgical removal of a unilateral structural abnormality resulted in good outcome.…”

Section: Discussionmentioning

confidence: 99%

Foramen ovale Recordings: A Presurgical Investigation in Epilepsy

Wieshmann

Denby²,

Eldridge³

et al. 2002

Eur Neurol

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The aim of our study was to determine when foramen ovale recordings add useful information to scalp EEG recordings and magnetic resonance imaging (MRI) with hippocampal measurements. We evaluated the outcome of 79 patients with non-lesional partial epilepsy with presumed temporal seizure onset. Ictal foramen ovale recordings were performed in 16 patients with normal MRI (‘MRI-negative group’) and 41 patients with lateralizing MRI but non-lateralizing scalp EEG (‘discordant group’). 22 patients with concordant MRI and scalp EEG were not investigated with foramen ovale recordings (‘concordant group’). The seizure-free rate was higher in concordant than discordant patients despite additional investigation with foramen ovale electrodes (71 and 55% seizure free, respectively). No useful localizing information was added with foramen ovale recordings in MRI-negative patients.

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“…18,20,21 High resolution magnetic resonance imaging (MRI) is recommended for visualization of the deep temporal lobe structures. 2,22 This is particularly important for reliable separation of the amygdala and hippocampus in order to obtain accurate volume measurements. 23 Given the similar clinical features and divergent treatments for these two diagnoses, it is imperative for the clinician to understand the neuroanatomical features of the temporal lobe and the noninvasive imaging techniques available to assist in decision-making.…”

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confidence: 99%

Sudden Onset Panic: Epileptic Aura or Panic Disorder?

Hurley¹,

Fisher²,

Taber³

2006

JNP

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Cover and Figure 1. The location and extent of the temporal lobe (pink), the hippocampus (green) and the amygdala (blue) are color-coded onto a lateral drawing of the brain and representative coronal and axial magnetic resonance (MR) images. Landmarks commonly used for identification of the boundary between the amygdala and anterior hippocampus are labeled in yellow. 1,2 The dashed lines on the lateral view of the brain indicate the locations and orientations for the two MR sections. Figure 2.Nuclear medicine scans obtained during a seizure (ictal scan) will show increased perfusion or metabolism in the epileptic focus (arrows), as illustrated here with both coronal and axial single photon emission computed tomography (SPECT) images of cerebral blood flow. Scans obtained in the absence of seizure (interictal scan) will show decreased perfusion or metabolism (arrows). Figure 3.Nuclear medicine scans acquired under resting conditions from patients with panic disorder have areas of increased (yellow, orange) and decreased (blue, green, purple) perfusion or metabolism compared with healthy individuals. 3-6 Reported differences were in the range of 5% to 10%, smaller than is typically seen in epilepsy.

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Failure of Standard Magnetic Resonance Imaging in Patients With Refractory Temporal Lobe Epilepsy

Cited by 58 publications

References 8 publications

Machine Learning of DTI Structural Brain Connectomes for Lateralization of Temporal Lobe Epilepsy

Machine Learning of DTI Structural Brain Connectomes for Lateralization of Temporal Lobe Epilepsy

Foramen ovale Recordings: A Presurgical Investigation in Epilepsy

Sudden Onset Panic: Epileptic Aura or Panic Disorder?

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