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Network-targeted approach and postoperative resting-state functional magnetic resonance imaging are associated with seizure outcome
- Source :
- Annals of neurologyReferences. 86(3)
- Publication Year :
- 2019
-
Abstract
- OBJECTIVE Postoperative resting-state functional magnetic resonance imaging (MRI) in children with intractable epilepsy has not been quantified in relation to seizure outcome. Therefore, its value as a biomarker for epileptogenic pathology is not well understood. METHODS In a sample of children with intractable epilepsy who underwent prospective resting-state seizure onset zone (SOZ)-targeted epilepsy surgery, postoperative resting-state functional MRI (rs-fMRI) was performed 6 to 12 months later. Graded normalization of the postoperative resting-state SOZ was compared to seizure outcomes, patient, surgery, and anatomical MRI characteristics. RESULTS A total of 64 cases were evaluated. Network-targeted surgery, followed by postoperative rs-fMRI normalization was significantly (p < 0.001) correlated with seizure reduction, with a Spearman rank correlation coefficient of 0.83. Of 39 cases with postoperative rs-fMRI SOZ normalization, 38 (97%) became completely seizure free. In contrast, of the 25 cases without complete rs-fMRI SOZ normalization, only 3 (5%) became seizure free. The accuracy of rs-fMRI as a biomarker predicting seizure freedom is 94%, with 96% sensitivity and 93% specificity. INTERPRETATION Among seizure localization techniques in pediatric epilepsy, network-targeted surgery, followed by postoperative rs-fMRI normalization, has high correlation with seizure freedom. This study shows that rs-fMRI SOZ can be used as a biomarker of the epileptogenic zone, and postoperative rs-fMRI normalization is a biomarker for SOZ quiescence. ANN NEUROL 2019;86:344-356.
- Subjects :
- 0301 basic medicine
Normalization (statistics)
Male
medicine.medical_specialty
Drug Resistant Epilepsy
Rest
Sensitivity and Specificity
03 medical and health sciences
0302 clinical medicine
Predictive Value of Tests
Seizures
Neural Pathways
Medicine
Humans
Epilepsy surgery
Single-Blind Method
Postoperative Period
Prospective Studies
Prospective cohort study
Child
medicine.diagnostic_test
business.industry
Seizure outcome
Brain
Magnetic resonance imaging
Magnetic Resonance Imaging
030104 developmental biology
Neurology
Predictive value of tests
Biomarker (medicine)
Female
Neurology (clinical)
Radiology
business
Functional magnetic resonance imaging
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 15318249
- Volume :
- 86
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Annals of neurologyReferences
- Accession number :
- edsair.doi.dedup.....13079d8d8154ce614735b97fb071bebe