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Clinical Trial
. 2019 Sep;86(3):344-356.
doi: 10.1002/ana.25547. Epub 2019 Jul 11.

Network-targeted approach and postoperative resting-state functional magnetic resonance imaging are associated with seizure outcome

Varina L Boerwinkle  1 , Emilio G Cediel  2 , Lucia Mirea  3 , Korwyn Williams  1 , John F Kerrigan  1 , Sandi Lam  4 , Jeffrey S Raskin  4 , Virendra R Desai  5 , Angus A Wilfong  1 , P David Adelson  1   2 , Daniel J Curry  6
Affiliations
Free article
Clinical Trial

Network-targeted approach and postoperative resting-state functional magnetic resonance imaging are associated with seizure outcome

Varina L Boerwinkle et al. Ann Neurol. 2019 Sep.
Free article

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.

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References

    1. Singh A, Trevick S. The epidemiology of global epilepsy. Neurol Clin 2016;34:837-847.
    1. Kwan P, Schachter SC, Brodie MJ. Drug-resistant epilepsy. N Engl J Med 2011;365:919-926.
    1. Engel J, McDermott MP, Wiebe S, et al. Early surgical therapy for drug-resistant temporal lobe epilepsy: a randomized trial. JAMA 2012;307:922-930.
    1. Fiest KM, Sajobi TT, Wiebe S. Epilepsy surgery and meaningful improvements in quality of life: results from a randomized controlled trial. Epilepsia 2014;55:886-892.
    1. Wiebe S, Blume WT, Girvin JP, Eliasziw M; Effectiveness and Efficiency of Surgery for Temporal Lobe Epilepsy Study Group. A randomized, controlled trial of surgery for temporal-lobe epilepsy. N Engl J Med 2001;345:311-318.

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