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1. Interpretable surface-based detection of focal cortical dysplasias: a Multi-centre Epilepsy Lesion Detection study

Author

Spitzer, Hannah, primary, Ripart, Mathilde, additional, Whitaker, Kirstie, additional, D’Arco, Felice, additional, Mankad, Kshitij, additional, Chen, Andrew A, additional, Napolitano, Antonio, additional, De Palma, Luca, additional, De Benedictis, Alessandro, additional, Foldes, Stephen, additional, Humphreys, Zachary, additional, Zhang, Kai, additional, Hu, Wenhan, additional, Mo, Jiajie, additional, Likeman, Marcus, additional, Davies, Shirin, additional, Güttler, Christopher, additional, Lenge, Matteo, additional, Cohen, Nathan T, additional, Tang, Yingying, additional, Wang, Shan, additional, Chari, Aswin, additional, Tisdall, Martin, additional, Bargallo, Nuria, additional, Conde-Blanco, Estefanía, additional, Pariente, Jose Carlos, additional, Pascual-Diaz, Saül, additional, Delgado-Martínez, Ignacio, additional, Pérez-Enríquez, Carmen, additional, Lagorio, Ilaria, additional, Abela, Eugenio, additional, Mullatti, Nandini, additional, O’Muircheartaigh, Jonathan, additional, Vecchiato, Katy, additional, Liu, Yawu, additional, Caligiuri, Maria Eugenia, additional, Sinclair, Ben, additional, Vivash, Lucy, additional, Willard, Anna, additional, Kandasamy, Jothy, additional, McLellan, Ailsa, additional, Sokol, Drahoslav, additional, Semmelroch, Mira, additional, Kloster, Ane G, additional, Opheim, Giske, additional, Ribeiro, Letícia, additional, Yasuda, Clarissa, additional, Rossi-Espagnet, Camilla, additional, Hamandi, Khalid, additional, Tietze, Anna, additional, Barba, Carmen, additional, Guerrini, Renzo, additional, Gaillard, William Davis, additional, You, Xiaozhen, additional, Wang, Irene, additional, González-Ortiz, Sofía, additional, Severino, Mariasavina, additional, Striano, Pasquale, additional, Tortora, Domenico, additional, Kälviäinen, Reetta, additional, Gambardella, Antonio, additional, Labate, Angelo, additional, Desmond, Patricia, additional, Lui, Elaine, additional, O’Brien, Terence, additional, Shetty, Jay, additional, Jackson, Graeme, additional, Duncan, John S, additional, Winston, Gavin P, additional, Pinborg, Lars H, additional, Cendes, Fernando, additional, Theis, Fabian J, additional, Shinohara, Russell T, additional, Cross, J Helen, additional, Baldeweg, Torsten, additional, Adler, Sophie, additional, and Wagstyl, Konrad, additional

Published
2022
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2. Interpretable surface-based detection of focal cortical dysplasias:a Multi-centre Epilepsy Lesion Detection study

Author

Spitzer, Hannah, Ripart, Mathilde, Whitaker, Kirstie, D’Arco, Felice, Mankad, Kshitij, Chen, Andrew A., Napolitano, Antonio, De Palma, Luca, De Benedictis, Alessandro, Foldes, Stephen, Humphreys, Zachary, Zhang, Kai, Hu, Wenhan, Mo, Jiajie, Likeman, Marcus, Davies, Shirin, Güttler, Christopher, Lenge, Matteo, Cohen, Nathan T., Tang, Yingying, Wang, Shan, Chari, Aswin, Tisdall, Martin, Bargallo, Nuria, Conde-Blanco, Estefanía, Pariente, Jose Carlos, Pascual-Diaz, Saül, Delgado-Martínez, Ignacio, Pérez-Enríquez, Carmen, Lagorio, Ilaria, Abela, Eugenio, Mullatti, Nandini, O’Muircheartaigh, Jonathan, Vecchiato, Katy, Liu, Yawu, Caligiuri, Maria Eugenia, Sinclair, Ben, Vivash, Lucy, Willard, Anna, Kandasamy, Jothy, McLellan, Ailsa, Sokol, Drahoslav, Semmelroch, Mira, Kloster, Ane G., Opheim, Giske, Ribeiro, Letícia, Yasuda, Clarissa, Rossi-Espagnet, Camilla, Hamandi, Khalid, Tietze, Anna, Barba, Carmen, Guerrini, Renzo, Gaillard, William Davis, You, Xiaozhen, Wang, Irene, González-Ortiz, Sofía, Severino, Mariasavina, Striano, Pasquale, Tortora, Domenico, Kälviäinen, Reetta, Gambardella, Antonio, Labate, Angelo, Desmond, Patricia, Lui, Elaine, O’Brien, Terence, Shetty, Jay, Jackson, Graeme, Duncan, John S., Winston, Gavin P., Pinborg, Lars H., Cendes, Fernando, Theis, Fabian J., Shinohara, Russell T., Cross, J. Helen, Baldeweg, Torsten, Adler, Sophie, Wagstyl, Konrad, Spitzer, Hannah, Ripart, Mathilde, Whitaker, Kirstie, D’Arco, Felice, Mankad, Kshitij, Chen, Andrew A., Napolitano, Antonio, De Palma, Luca, De Benedictis, Alessandro, Foldes, Stephen, Humphreys, Zachary, Zhang, Kai, Hu, Wenhan, Mo, Jiajie, Likeman, Marcus, Davies, Shirin, Güttler, Christopher, Lenge, Matteo, Cohen, Nathan T., Tang, Yingying, Wang, Shan, Chari, Aswin, Tisdall, Martin, Bargallo, Nuria, Conde-Blanco, Estefanía, Pariente, Jose Carlos, Pascual-Diaz, Saül, Delgado-Martínez, Ignacio, Pérez-Enríquez, Carmen, Lagorio, Ilaria, Abela, Eugenio, Mullatti, Nandini, O’Muircheartaigh, Jonathan, Vecchiato, Katy, Liu, Yawu, Caligiuri, Maria Eugenia, Sinclair, Ben, Vivash, Lucy, Willard, Anna, Kandasamy, Jothy, McLellan, Ailsa, Sokol, Drahoslav, Semmelroch, Mira, Kloster, Ane G., Opheim, Giske, Ribeiro, Letícia, Yasuda, Clarissa, Rossi-Espagnet, Camilla, Hamandi, Khalid, Tietze, Anna, Barba, Carmen, Guerrini, Renzo, Gaillard, William Davis, You, Xiaozhen, Wang, Irene, González-Ortiz, Sofía, Severino, Mariasavina, Striano, Pasquale, Tortora, Domenico, Kälviäinen, Reetta, Gambardella, Antonio, Labate, Angelo, Desmond, Patricia, Lui, Elaine, O’Brien, Terence, Shetty, Jay, Jackson, Graeme, Duncan, John S., Winston, Gavin P., Pinborg, Lars H., Cendes, Fernando, Theis, Fabian J., Shinohara, Russell T., Cross, J. Helen, Baldeweg, Torsten, Adler, Sophie, and Wagstyl, Konrad

Abstract

One outstanding challenge for machine learning in diagnostic biomedical imaging is algorithm interpretability. A key application is the identification of subtle epileptogenic focal cortical dysplasias (FCDs) from structural MRI. FCDs are difficult to visualize on structural MRI but are often amenable to surgical resection. We aimed to develop an open-source, interpretable, surface-based machine-learning algorithm to automatically identify FCDs on heterogeneous structural MRI data from epilepsy surgery centres worldwide. The Multi-centre Epilepsy Lesion Detection (MELD) Project collated and harmonized a retrospective MRI cohort of 1015 participants, 618 patients with focal FCD-related epilepsy and 397 controls, from 22 epilepsy centres worldwide. We created a neural network for FCD detection based on 33 surface-based features. The network was trained and cross-validated on 50% of the total cohort and tested on the remaining 50% as well as on 2 independent test sites. Multidimensional feature analysis and integrated gradient saliencies were used to interrogate network performance. Our pipeline outputs individual patient reports, which identify the location of predicted lesions, alongside their imaging features and relative saliency to the classifier. On a restricted ‘gold-standard’ subcohort of seizure-free patients with FCD type IIB who had T1 and fluid-attenuated inversion recovery MRI data, the MELD FCD surface-based algorithm had a sensitivity of 85%. Across the entire withheld test cohort the sensitivity was 59% and specificity was 54%. After including a border zone around lesions, to account for uncertainty around the borders of manually delineated lesion masks, the sensitivity was 67%. This multicentre, multinational study with open access protocols and code has developed a robust and interpretable machine-learning algorithm for automated detection of focal cortical dysplasias, giving physicians greater confidence in the identification of subtle M

Published
2022

3. Atlas of lesion locations and postsurgical seizure freedom in focal cortical dysplasia:A MELD study

Author

Wagstyl, Konrad, Whitaker, Kirstie, Raznahan, Armin, Seidlitz, Jakob, Vértes, Petra E., Foldes, Stephen, Humphreys, Zachary, Hu, Wenhan, Mo, Jiajie, Likeman, Marcus, Davies, Shirin, Lenge, Matteo, Cohen, Nathan T., Tang, Yingying, Wang, Shan, Ripart, Mathilde, Chari, Aswin, Tisdall, Martin, Bargallo, Nuria, Conde-Blanco, Estefanía, Pariente, Jose Carlos, Pascual-Diaz, Saül, Delgado-Martínez, Ignacio, Pérez-Enríquez, Carmen, Lagorio, Ilaria, Abela, Eugenio, Mullatti, Nandini, O'Muircheartaigh, Jonathan, Vecchiato, Katy, Liu, Yawu, Caligiuri, Maria, Sinclair, Ben, Vivash, Lucy, Willard, Anna, Kandasamy, Jothy, McLellan, Ailsa, Sokol, Drahoslav, Semmelroch, Mira, Kloster, Ane, Opheim, Giske, Yasuda, Clarissa, Zhang, Kai, Hamandi, Khalid, Barba, Carmen, Guerrini, Renzo, Gaillard, William Davis, You, Xiaozhen, Wang, Irene, González-Ortiz, Sofía, Severino, Mariasavina, Striano, Pasquale, Tortora, Domenico, Kalviainen, Reetta, Gambardella, Antonio, Labate, Angelo, Desmond, Patricia, Lui, Elaine, O'Brien, Terry, Shetty, Jay, Jackson, Graeme, Duncan, John S., Winston, Gavin P., Pinborg, Lars, Cendes, Fernando, Cross, Judith Helen, Baldeweg, Torsten, Adler, Sophie, Wagstyl, Konrad, Whitaker, Kirstie, Raznahan, Armin, Seidlitz, Jakob, Vértes, Petra E., Foldes, Stephen, Humphreys, Zachary, Hu, Wenhan, Mo, Jiajie, Likeman, Marcus, Davies, Shirin, Lenge, Matteo, Cohen, Nathan T., Tang, Yingying, Wang, Shan, Ripart, Mathilde, Chari, Aswin, Tisdall, Martin, Bargallo, Nuria, Conde-Blanco, Estefanía, Pariente, Jose Carlos, Pascual-Diaz, Saül, Delgado-Martínez, Ignacio, Pérez-Enríquez, Carmen, Lagorio, Ilaria, Abela, Eugenio, Mullatti, Nandini, O'Muircheartaigh, Jonathan, Vecchiato, Katy, Liu, Yawu, Caligiuri, Maria, Sinclair, Ben, Vivash, Lucy, Willard, Anna, Kandasamy, Jothy, McLellan, Ailsa, Sokol, Drahoslav, Semmelroch, Mira, Kloster, Ane, Opheim, Giske, Yasuda, Clarissa, Zhang, Kai, Hamandi, Khalid, Barba, Carmen, Guerrini, Renzo, Gaillard, William Davis, You, Xiaozhen, Wang, Irene, González-Ortiz, Sofía, Severino, Mariasavina, Striano, Pasquale, Tortora, Domenico, Kalviainen, Reetta, Gambardella, Antonio, Labate, Angelo, Desmond, Patricia, Lui, Elaine, O'Brien, Terry, Shetty, Jay, Jackson, Graeme, Duncan, John S., Winston, Gavin P., Pinborg, Lars, Cendes, Fernando, Cross, Judith Helen, Baldeweg, Torsten, and Adler, Sophie

Abstract

Objective: Drug-resistant focal epilepsy is often caused by focal cortical dysplasias (FCDs). The distribution of these lesions across the cerebral cortex and the impact of lesion location on clinical presentation and surgical outcome are largely unknown. We created a neuroimaging cohort of patients with individually mapped FCDs to determine factors associated with lesion location and predictors of postsurgical outcome. Methods: The MELD (Multi-centre Epilepsy Lesion Detection) project collated a retrospective cohort of 580 patients with epilepsy attributed to FCD from 20 epilepsy centers worldwide. Magnetic resonance imaging-based maps of individual FCDs with accompanying demographic, clinical, and surgical information were collected. We mapped the distribution of FCDs, examined for associations between clinical factors and lesion location, and developed a predictive model of postsurgical seizure freedom. Results: FCDs were nonuniformly distributed, concentrating in the superior frontal sulcus, frontal pole, and temporal pole. Epilepsy onset was typically before the age of 10 years. Earlier epilepsy onset was associated with lesions in primary sensory areas, whereas later epilepsy onset was associated with lesions in association cortices. Lesions in temporal and occipital lobes tended to be larger than frontal lobe lesions. Seizure freedom rates varied with FCD location, from around 30% in visual, motor, and premotor areas to 75% in superior temporal and frontal gyri. The predictive model of postsurgical seizure freedom had a positive predictive value of 70% and negative predictive value of 61%. Significance: FCD location is an important determinant of its size, the age at epilepsy onset, and the likelihood of seizure freedom postsurgery. Our atlas of lesion locations can be used to guide the radiological search for subtle lesions in individual patients. Our atlas of regional seizure freedom rates and associated predictive model can be used to estimate individua

Published
2022

4. Interpretable surface-based detection of focal cortical dysplasias: a MELD study

Author

Spitzer, Hannah, primary, Ripart, Mathilde, additional, Whitaker, Kirstie, additional, Napolitano, Antonio, additional, De Palma, Luca, additional, De Benedictis, Alessandro, additional, Foldes, Stephen, additional, Humphreys, Zachary, additional, Zhang, Kai, additional, Hu, Wenhan, additional, Mo, Jiajie, additional, Likeman, Marcus, additional, Davies, Shirin, additional, Guttler, Christopher, additional, Lenge, Matteo, additional, Cohen, Nathan T., additional, Tang, Yingying, additional, Wang, Shan, additional, Chari, Aswin, additional, Tisdall, Martin, additional, Bargallo, Nuria, additional, Conde-Blanco, Estefanía, additional, Pariente, Jose Carlos, additional, Pascual-Diaz, Saül, additional, Delgado-Martínez, Ignacio, additional, Pérez-Enríquez, Carmen, additional, Lagorio, Ilaria, additional, Abela, Eugenio, additional, Mullatti, Nandini, additional, O’Muircheartaigh, Jonathan, additional, Vecchiato, Katy, additional, Liu, Yawu, additional, Caligiuri, Maria, additional, Sinclair, Ben, additional, Vivash, Lucy, additional, Willard, Anna, additional, Kandasamy, Jothy, additional, McLellan, Ailsa, additional, Sokol, Drahoslav, additional, Semmelroch, Mira, additional, Kloster, Ane, additional, Opheim, Giske, additional, Ribeiro, Letícia, additional, Yasuda, Clarissa, additional, Rossi-Espagnet, Camilla, additional, Hamandi, Khalid, additional, Tietze, Anna, additional, Barba, Carmen, additional, Guerrini, Renzo, additional, Gaillard, William Davis, additional, You, Xiaozhen, additional, Wang, Irene, additional, González-Ortiz, Sofía, additional, Severino, Mariasavina, additional, Striano, Pasquale, additional, Tortora, Domenico, additional, Kalviainen, Reetta, additional, Gambardella, Antonio, additional, Labate, Angelo, additional, Desmond, Patricia, additional, Lui, Elaine, additional, O’Brien, Terence, additional, Shetty, Jay, additional, Jackson, Graeme, additional, Duncan, John, additional, Winston, Gavin, additional, Pinborg, Lars, additional, Cendes, Fernando, additional, Theis, Fabian J., additional, Shinohara, Russell T., additional, Cross, J Helen, additional, Baldeweg, Torsten, additional, Adler, Sophie, additional, and Wagstyl, Konrad, additional

Published
2021
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5. Atlas of lesion locations and postsurgical seizure freedom in focal cortical dysplasia: A MELD study

Author

Wagstyl, Konrad, primary, Whitaker, Kirstie, additional, Raznahan, Armin, additional, Seidlitz, Jakob, additional, Vértes, Petra E., additional, Foldes, Stephen, additional, Humphreys, Zachary, additional, Hu, Wenhan, additional, Mo, Jiajie, additional, Likeman, Marcus, additional, Davies, Shirin, additional, Lenge, Matteo, additional, Cohen, Nathan T., additional, Tang, Yingying, additional, Wang, Shan, additional, Ripart, Mathilde, additional, Chari, Aswin, additional, Tisdall, Martin, additional, Bargallo, Nuria, additional, Conde‐Blanco, Estefanía, additional, Pariente, Jose Carlos, additional, Pascual‐Diaz, Saül, additional, Delgado‐Martínez, Ignacio, additional, Pérez‐Enríquez, Carmen, additional, Lagorio, Ilaria, additional, Abela, Eugenio, additional, Mullatti, Nandini, additional, O'Muircheartaigh, Jonathan, additional, Vecchiato, Katy, additional, Liu, Yawu, additional, Caligiuri, Maria, additional, Sinclair, Ben, additional, Vivash, Lucy, additional, Willard, Anna, additional, Kandasamy, Jothy, additional, McLellan, Ailsa, additional, Sokol, Drahoslav, additional, Semmelroch, Mira, additional, Kloster, Ane, additional, Opheim, Giske, additional, Yasuda, Clarissa, additional, Zhang, Kai, additional, Hamandi, Khalid, additional, Barba, Carmen, additional, Guerrini, Renzo, additional, Gaillard, William Davis, additional, You, Xiaozhen, additional, Wang, Irene, additional, González‐Ortiz, Sofía, additional, Severino, Mariasavina, additional, Striano, Pasquale, additional, Tortora, Domenico, additional, Kalviainen, Reetta, additional, Gambardella, Antonio, additional, Labate, Angelo, additional, Desmond, Patricia, additional, Lui, Elaine, additional, O'Brien, Terry, additional, Shetty, Jay, additional, Jackson, Graeme, additional, Duncan, John S., additional, Winston, Gavin P., additional, Pinborg, Lars, additional, Cendes, Fernando, additional, Cross, Judith Helen, additional, Baldeweg, Torsten, additional, and Adler, Sophie, additional

Published
2021
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6. Networks Underlie Temporal Onset of Dysplasia-Related Epilepsy: A MELD Study.

Author

Cohen, Nathan T., You, Xiaozhen, Krishnamurthy, Manu, Sepeta, Leigh N., Zhang, Anqing, Oluigbo, Chima, Whitehead, Matthew T., Gholipour, Taha, Baldeweg, Torsten, Wagstyl, Konrad, Adler, Sophie, Gaillard, William D., Ripart, Mathilde, Whitaker, Kirstie, Napolitano, Antonio, De Palma, Luca, De Benedictis, Alessandro, Foldes, Stephen, Humphreys, Zachary, and Zhang, Kai

Abstract

Objective: The purpose of this study was to evaluate if focal cortical dysplasia (FCD) co-localization to cortical functional networks is associated with the temporal distribution of epilepsy onset in FCD.Methods: International (20 center), retrospective cohort from the Multi-Centre Epilepsy Lesion Detection (MELD) project. Patients included if >3 years old, had 3D pre-operative T1 magnetic resonance imaging (MRI; 1.5 or 3 T) with radiologic or histopathologic FCD after surgery. Images processed using the MELD protocol, masked with 3D regions-of-interest (ROI), and co-registered to fsaverage_sym (symmetric template). FCDs were then co-localized to 1 of 7 distributed functional cortical networks. Negative binomial regression evaluated effect of FCD size, network, histology, and sulcal depth on age of epilepsy onset. From this model, predictive age of epilepsy onset was calculated for each network.Results: Three hundred eighty-eight patients had median age seizure onset 5 years (interquartile range [IQR] = 3-11 years), median age at pre-operative scan 18 years (IQR = 11-28 years). FCDs co-localized to the following networks: limbic (90), default mode (87), somatomotor (65), front parietal control (52), ventral attention (32), dorsal attention (31), and visual (31). Larger lesions were associated with younger age of onset (p = 0.01); age of epilepsy onset was associated with dominant network (p = 0.04) but not sulcal depth or histology. Sensorimotor networks had youngest onset; the limbic network had oldest age of onset (p values <0.05).Interpretation: FCD co-localization to distributed functional cortical networks is associated with age of epilepsy onset: sensory neural networks (somatomotor and visual) with earlier onset, and limbic latest onset. These variations may reflect developmental differences in synaptic/white matter maturation or network activation and may provide a biological basis for age-dependent epilepsy onset expression. ANN NEUROL 2022;92:503-511. [ABSTRACT FROM AUTHOR]

Published
2022
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7. MELD Project: Atlas of lesion locations and postsurgical seizure freedom in focal cortical dysplasia

Author

Wagstyl, Konrad, primary, Whitaker, Kirstie, additional, Raznahan, Armin, additional, Seidlitz, Jakob, additional, Vértes, Petra E, additional, Foldes, Stephen, additional, Humphreys, Zachary, additional, Hu, Wenhan, additional, Mo, Jiajie, additional, Likeman, Marcus, additional, Davies, Shirin, additional, Lenge, Matteo, additional, Cohen, Nathan T, additional, Tang, Yingying, additional, Wang, Shan, additional, Ripart, Mathilde, additional, Chari, Aswin, additional, Tisdall, Martin, additional, Bargallo, Nuria, additional, Conde-Blanco, Estefanía, additional, Pariente, Jose Carlos, additional, Pascual-Diaz, Saül, additional, Delgado-Martínez, Ignacio, additional, Pérez-Enríquez, Carmen, additional, Lagorio, Ilaria, additional, Abela, Eugenio, additional, Mullatti, Nandini, additional, O’Muircheartaigh, Jonathan, additional, Vecchiato, Katy, additional, Liu, Yawu, additional, Caligiuri, Maria, additional, Sinclair, Ben, additional, Vivash, Lucy, additional, Willard, Anna, additional, Kandasamy, Jothy, additional, McLellan, Ailsa, additional, Sokol, Drahoslav, additional, Semmelroch, Mira, additional, Kloster, Ane, additional, Opheim, Giske, additional, Yasuda, Clarissa, additional, Zhang, Kai, additional, Hamandi, Khalid, additional, Barba, Carmen, additional, Guerrini, Renzo, additional, Gaillard, William Davis, additional, You, Xiaozhen, additional, Wang, Irene, additional, González-Ortiz, Sofía, additional, Severino, Mariasavina, additional, Striano, Pasquale, additional, Tortora, Domenico, additional, Kalviainen, Reetta, additional, Gambardella, Antonio, additional, Labate, Angelo, additional, Desmond, Patricia, additional, Lui, Elaine, additional, O’Brien, Terry, additional, Shetty, Jay, additional, Jackson, Graeme, additional, Duncan, John S, additional, Winston, Gavin P, additional, Pinborg, Lars, additional, Cendes, Fernando, additional, Cross, J Helen, additional, Baldeweg, Torsten, additional, and Adler, Sophie, additional

Published
2021
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8. Atlas of lesion locations and postsurgical seizure freedom in focal cortical dysplasia: A MELD study.

Author

Wagstyl, Konrad, Whitaker, Kirstie, Raznahan, Armin, Seidlitz, Jakob, Vértes, Petra E., Foldes, Stephen, Humphreys, Zachary, Hu, Wenhan, Mo, Jiajie, Likeman, Marcus, Davies, Shirin, Lenge, Matteo, Cohen, Nathan T., Tang, Yingying, Wang, Shan, Ripart, Mathilde, Chari, Aswin, Tisdall, Martin, Bargallo, Nuria, and Conde‐Blanco, Estefanía

Subjects
EPILEPSY, PARTIAL epilepsy, SEIZURES (Medicine), OCCIPITAL lobe, FRONTAL lobe, FOCAL cortical dysplasia, CEREBRAL cortex
Abstract

Objective: Drug‐resistant focal epilepsy is often caused by focal cortical dysplasias (FCDs). The distribution of these lesions across the cerebral cortex and the impact of lesion location on clinical presentation and surgical outcome are largely unknown. We created a neuroimaging cohort of patients with individually mapped FCDs to determine factors associated with lesion location and predictors of postsurgical outcome. Methods: The MELD (Multi‐centre Epilepsy Lesion Detection) project collated a retrospective cohort of 580 patients with epilepsy attributed to FCD from 20 epilepsy centers worldwide. Magnetic resonance imaging‐based maps of individual FCDs with accompanying demographic, clinical, and surgical information were collected. We mapped the distribution of FCDs, examined for associations between clinical factors and lesion location, and developed a predictive model of postsurgical seizure freedom. Results: FCDs were nonuniformly distributed, concentrating in the superior frontal sulcus, frontal pole, and temporal pole. Epilepsy onset was typically before the age of 10 years. Earlier epilepsy onset was associated with lesions in primary sensory areas, whereas later epilepsy onset was associated with lesions in association cortices. Lesions in temporal and occipital lobes tended to be larger than frontal lobe lesions. Seizure freedom rates varied with FCD location, from around 30% in visual, motor, and premotor areas to 75% in superior temporal and frontal gyri. The predictive model of postsurgical seizure freedom had a positive predictive value of 70% and negative predictive value of 61%. Significance: FCD location is an important determinant of its size, the age at epilepsy onset, and the likelihood of seizure freedom postsurgery. Our atlas of lesion locations can be used to guide the radiological search for subtle lesions in individual patients. Our atlas of regional seizure freedom rates and associated predictive model can be used to estimate individual likelihoods of postsurgical seizure freedom. Data‐driven atlases and predictive models are essential for evidence‐based, precision medicine and risk counseling in epilepsy. [ABSTRACT FROM AUTHOR]

Published
2022
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