Evidence map›Paper›PMID 31599323›Full record

ArticleBrain : a journal of neurology2019

Virtual resection predicts surgical outcome for drug-resistant epilepsy.

Lohith G Kini, John M Bernabei, Fadi Mikhail, Peter Hadar, Preya Shah, Ankit N Khambhati, Kelly Oechsel, Ryan Archer, Jacqueline Boccanfuso, Erin Conrad and 8 more

Erratum issuedAbstract read
In one paragraph

Article in Brain : a journal of neurology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 71 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
71citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

71 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Article
  6. Review
  7. The neurotoxic legacy of CAR-T cells: where do we stand?Therapeutic advances in neurological disorders · 2026
    Review
  8. Article
  9. Article
  10. Article
  11. Review
  12. Review
  13. Article
  14. Article
  15. Article
  16. Article
  17. Cenobamate for Difficult-to-Treat Epilepsy - Selected Case Vignettes.Neuropsychiatric disease and treatment · 2025
    Article
  18. Article
  19. Article
  20. Article

11 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

18 authors.

Lohith G KiniDepartment of Bioengineering, University of Pennsylvania, Philadelphia PA 19104, USA.
John M BernabeiDepartment of Bioengineering, University of Pennsylvania, Philadelphia PA 19104, USA.
Fadi MikhailCenter for Neuroengineering and Therapeutics, University of Pennsylvania, Philadelphia PA 19104, USA.
Peter HadarCenter for Neuroengineering and Therapeutics, University of Pennsylvania, Philadelphia PA 19104, USA.
Preya ShahDepartment of Bioengineering, University of Pennsylvania, Philadelphia PA 19104, USA.
Ankit N KhambhatiDepartment of Neurological Surgery, University of California San Francisco, San Francisco CA 94143, USA.
Kelly OechselCenter for Neuroengineering and Therapeutics, University of Pennsylvania, Philadelphia PA 19104, USA.
Ryan ArcherCenter for Neuroengineering and Therapeutics, University of Pennsylvania, Philadelphia PA 19104, USA.
Jacqueline BoccanfusoCenter for Neuroengineering and Therapeutics, University of Pennsylvania, Philadelphia PA 19104, USA.
Erin ConradDepartment of Neurology, Hospital of the University of Pennsylvania, Philadelphia PA 19104, USA.
Russell T ShinoharaDepartment of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia PA 19104, USA.
Joel M SteinDepartment of Radiology, Hospital of the University of Pennsylvania, Philadelphia PA 19104, USA.
Sandhitsu DasDepartment of Neurology, Hospital of the University of Pennsylvania, Philadelphia PA 19104, USA.
Ammar KhederDepartment of Neurology, Hospital of the University of Pennsylvania, Philadelphia PA 19104, USA.
Timothy H LucasDepartment of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia PA 19104, USA.
Kathryn A DavisCenter for Neuroengineering and Therapeutics, University of Pennsylvania, Philadelphia PA 19104, USA.
Danielle S BassettDepartment of Bioengineering, University of Pennsylvania, Philadelphia PA 19104, USA.
Brian LittDepartment of Bioengineering, University of Pennsylvania, Philadelphia PA 19104, USA.

Funding

Research Training Program in Disease Oriented Neuroscience (R25)R25NS065745 · NINDS · UNIVERSITY OF PENNSYLVANIA · PI DETRE, JOHN A · 2009 to 2023
$3.0M
Virtual Resection to Treat EpilepsyR01NS099348 · NINDS · UNIVERSITY OF PENNSYLVANIA · PI BASSETT, DANIELLE SMITH, LITT, BRIAN · 2016 to 2019
$2.3M
Localizing epileptic networks using novel 7T MRI glutamate imagingK23NS092973 · NINDS · UNIVERSITY OF PENNSYLVANIA · PI DAVIS, KATHRYN ADAMIAK · 2016 to 2020
$980k
NINDS NIH HHS R25 NS065745
6 · The paper itself

Abstract

Patients with drug-resistant epilepsy often require surgery to become seizure-free. While laser ablation and implantable stimulation devices have lowered the morbidity of these procedures, seizure-free rates have not dramatically improved, particularly for patients without focal lesions. This is in part because it is often unclear where to intervene in these cases. To address this clinical need, several research groups have published methods to map epileptic networks but applying them to improve patient care remains a challenge. In this study we advance clinical translation of these methods by: (i) presenting and sharing a robust pipeline to rigorously quantify the boundaries of the resection zone and determining which intracranial EEG electrodes lie within it; (ii) validating a brain network model on a retrospective cohort of 28 patients with drug-resistant epilepsy implanted with intracranial electrodes prior to surgical resection; and (iii) sharing all neuroimaging, annotated electrophysiology, and clinical metadata to facilitate future collaboration. Our network methods accurately forecast whether patients are likely to benefit from surgical intervention based on synchronizability of intracranial EEG (area under the receiver operating characteristic curve of 0.89) and provide novel information that traditional electrographic features do not. We further report that removing synchronizing brain regions is associated with improved clinical outcome, and postulate that sparing desynchronizing regions may further be beneficial. Our findings suggest that data-driven network-based methods can identify patients likely to benefit from resective or ablative therapy, and perhaps prevent invasive interventions in those unlikely to do so.

Indexed as

ElectrocorticographyNeuroimagingNeurosurgical ProceduresAdolescentAdultBrainDrug Resistant EpilepsyFemaleHumansImage Processing, Computer-AssistedMagnetic Resonance ImagingMaleMiddle AgedPrognosisRetrospective StudiesTreatment Outcomeelectrocorticographyepilepsy surgeryfunctional connectivitynetwork neuroscienceseizures

Identifiers

PMID31599323
PMCPMC6885672

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.