Evidence map›Paper›PMID 33361262›Full record

ArticleNeurology2021

Structural Brain Network Abnormalities and the Probability of Seizure Recurrence After Epilepsy Surgery.

Nishant Sinha, Yujiang Wang, Nádia Moreira da Silva, Anna Miserocchi, Andrew W McEvoy, Jane de Tisi, Sjoerd B Vos, Gavin P Winston, John S Duncan, Peter N Taylor

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 56 papers.

0numbers the graph read from it
0cells of the map it votes in
56citing papers in PubMed
6.6field-weighted citation impact, top 2% of its field
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

56 citing papers in PubMed, 94 citations in OpenAlex.

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  15. Periodic discharges in portable EEG of critically ill patients with altered mentation; an alerting and alarming phenomena with helpful clues.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 1 institution in 2 countries.

Nishant SinhaFrom the Translational and Clinical Research Institute (N.S.), Faculty of Medical Sciences, and Computational Neuroscience, Neurology, and Psychiatry Lab (N.S., Y.W., N.M.d.S., P.N.T.), Interdisciplinary Computing and Complex BioSystems Group, School of Computing, Newcastle University, Newcastle Upon Tyne; NIHR University College London Hospitals Biomedical Research Centre (Y.W., A.M., A.W.M., J.d.T., S.B.V., G.P.W., J.S.D., P.N.T.), UCL Institute of Neurology, Queen Square; Centre for Medical Image Computing (S.B.V.), University College London; Epilepsy Society MRI Unit (S.B.V., G.P.W., J.S.D), Chalfont St Peter, UK; and Department of Medicine (G.P.W.,), Division of Neurology, Queen's University, Kingston, Ontario, Canada. nishant.sinha89@gmail.com Peter.taylor@newcastle.ac.uk.ORCID 0000-0002-2090-4889
Yujiang WangFrom the Translational and Clinical Research Institute (N.S.), Faculty of Medical Sciences, and Computational Neuroscience, Neurology, and Psychiatry Lab (N.S., Y.W., N.M.d.S., P.N.T.), Interdisciplinary Computing and Complex BioSystems Group, School of Computing, Newcastle University, Newcastle Upon Tyne; NIHR University College London Hospitals Biomedical Research Centre (Y.W., A.M., A.W.M., J.d.T., S.B.V., G.P.W., J.S.D., P.N.T.), UCL Institute of Neurology, Queen Square; Centre for Medical Image Computing (S.B.V.), University College London; Epilepsy Society MRI Unit (S.B.V., G.P.W., J.S.D), Chalfont St Peter, UK; and Department of Medicine (G.P.W.,), Division of Neurology, Queen's University, Kingston, Ontario, Canada.
Nádia Moreira da SilvaFrom the Translational and Clinical Research Institute (N.S.), Faculty of Medical Sciences, and Computational Neuroscience, Neurology, and Psychiatry Lab (N.S., Y.W., N.M.d.S., P.N.T.), Interdisciplinary Computing and Complex BioSystems Group, School of Computing, Newcastle University, Newcastle Upon Tyne; NIHR University College London Hospitals Biomedical Research Centre (Y.W., A.M., A.W.M., J.d.T., S.B.V., G.P.W., J.S.D., P.N.T.), UCL Institute of Neurology, Queen Square; Centre for Medical Image Computing (S.B.V.), University College London; Epilepsy Society MRI Unit (S.B.V., G.P.W., J.S.D), Chalfont St Peter, UK; and Department of Medicine (G.P.W.,), Division of Neurology, Queen's University, Kingston, Ontario, Canada.
Anna MiserocchiFrom the Translational and Clinical Research Institute (N.S.), Faculty of Medical Sciences, and Computational Neuroscience, Neurology, and Psychiatry Lab (N.S., Y.W., N.M.d.S., P.N.T.), Interdisciplinary Computing and Complex BioSystems Group, School of Computing, Newcastle University, Newcastle Upon Tyne; NIHR University College London Hospitals Biomedical Research Centre (Y.W., A.M., A.W.M., J.d.T., S.B.V., G.P.W., J.S.D., P.N.T.), UCL Institute of Neurology, Queen Square; Centre for Medical Image Computing (S.B.V.), University College London; Epilepsy Society MRI Unit (S.B.V., G.P.W., J.S.D), Chalfont St Peter, UK; and Department of Medicine (G.P.W.,), Division of Neurology, Queen's University, Kingston, Ontario, Canada.
Andrew W McEvoyFrom the Translational and Clinical Research Institute (N.S.), Faculty of Medical Sciences, and Computational Neuroscience, Neurology, and Psychiatry Lab (N.S., Y.W., N.M.d.S., P.N.T.), Interdisciplinary Computing and Complex BioSystems Group, School of Computing, Newcastle University, Newcastle Upon Tyne; NIHR University College London Hospitals Biomedical Research Centre (Y.W., A.M., A.W.M., J.d.T., S.B.V., G.P.W., J.S.D., P.N.T.), UCL Institute of Neurology, Queen Square; Centre for Medical Image Computing (S.B.V.), University College London; Epilepsy Society MRI Unit (S.B.V., G.P.W., J.S.D), Chalfont St Peter, UK; and Department of Medicine (G.P.W.,), Division of Neurology, Queen's University, Kingston, Ontario, Canada.
Jane de TisiFrom the Translational and Clinical Research Institute (N.S.), Faculty of Medical Sciences, and Computational Neuroscience, Neurology, and Psychiatry Lab (N.S., Y.W., N.M.d.S., P.N.T.), Interdisciplinary Computing and Complex BioSystems Group, School of Computing, Newcastle University, Newcastle Upon Tyne; NIHR University College London Hospitals Biomedical Research Centre (Y.W., A.M., A.W.M., J.d.T., S.B.V., G.P.W., J.S.D., P.N.T.), UCL Institute of Neurology, Queen Square; Centre for Medical Image Computing (S.B.V.), University College London; Epilepsy Society MRI Unit (S.B.V., G.P.W., J.S.D), Chalfont St Peter, UK; and Department of Medicine (G.P.W.,), Division of Neurology, Queen's University, Kingston, Ontario, Canada.
Sjoerd B VosFrom the Translational and Clinical Research Institute (N.S.), Faculty of Medical Sciences, and Computational Neuroscience, Neurology, and Psychiatry Lab (N.S., Y.W., N.M.d.S., P.N.T.), Interdisciplinary Computing and Complex BioSystems Group, School of Computing, Newcastle University, Newcastle Upon Tyne; NIHR University College London Hospitals Biomedical Research Centre (Y.W., A.M., A.W.M., J.d.T., S.B.V., G.P.W., J.S.D., P.N.T.), UCL Institute of Neurology, Queen Square; Centre for Medical Image Computing (S.B.V.), University College London; Epilepsy Society MRI Unit (S.B.V., G.P.W., J.S.D), Chalfont St Peter, UK; and Department of Medicine (G.P.W.,), Division of Neurology, Queen's University, Kingston, Ontario, Canada.ORCID 0000-0002-8502-4487
Gavin P WinstonFrom the Translational and Clinical Research Institute (N.S.), Faculty of Medical Sciences, and Computational Neuroscience, Neurology, and Psychiatry Lab (N.S., Y.W., N.M.d.S., P.N.T.), Interdisciplinary Computing and Complex BioSystems Group, School of Computing, Newcastle University, Newcastle Upon Tyne; NIHR University College London Hospitals Biomedical Research Centre (Y.W., A.M., A.W.M., J.d.T., S.B.V., G.P.W., J.S.D., P.N.T.), UCL Institute of Neurology, Queen Square; Centre for Medical Image Computing (S.B.V.), University College London; Epilepsy Society MRI Unit (S.B.V., G.P.W., J.S.D), Chalfont St Peter, UK; and Department of Medicine (G.P.W.,), Division of Neurology, Queen's University, Kingston, Ontario, Canada.
John S DuncanFrom the Translational and Clinical Research Institute (N.S.), Faculty of Medical Sciences, and Computational Neuroscience, Neurology, and Psychiatry Lab (N.S., Y.W., N.M.d.S., P.N.T.), Interdisciplinary Computing and Complex BioSystems Group, School of Computing, Newcastle University, Newcastle Upon Tyne; NIHR University College London Hospitals Biomedical Research Centre (Y.W., A.M., A.W.M., J.d.T., S.B.V., G.P.W., J.S.D., P.N.T.), UCL Institute of Neurology, Queen Square; Centre for Medical Image Computing (S.B.V.), University College London; Epilepsy Society MRI Unit (S.B.V., G.P.W., J.S.D), Chalfont St Peter, UK; and Department of Medicine (G.P.W.,), Division of Neurology, Queen's University, Kingston, Ontario, Canada.
Peter N TaylorFrom the Translational and Clinical Research Institute (N.S.), Faculty of Medical Sciences, and Computational Neuroscience, Neurology, and Psychiatry Lab (N.S., Y.W., N.M.d.S., P.N.T.), Interdisciplinary Computing and Complex BioSystems Group, School of Computing, Newcastle University, Newcastle Upon Tyne; NIHR University College London Hospitals Biomedical Research Centre (Y.W., A.M., A.W.M., J.d.T., S.B.V., G.P.W., J.S.D., P.N.T.), UCL Institute of Neurology, Queen Square; Centre for Medical Image Computing (S.B.V.), University College London; Epilepsy Society MRI Unit (S.B.V., G.P.W., J.S.D), Chalfont St Peter, UK; and Department of Medicine (G.P.W.,), Division of Neurology, Queen's University, Kingston, Ontario, Canada.ORCID 0000-0003-2144-9838
Queen's University · CA

Funding

Department of HealthMedical Research Council G0802012Medical Research Council MR/M00841X/1Wellcome Trust 105617/Z/14/ZWellcome Trust 208940/Z/17/ZWellcome Trust 210109/Z/18/Z
6 · The paper itself

Abstract

objectiveWe assessed preoperative structural brain networks and clinical characteristics of patients with drug-resistant temporal lobe epilepsy (TLE) to identify correlates of postsurgical seizure recurrences.

methodsWe examined data from 51 patients with TLE who underwent anterior temporal lobe resection (ATLR) and 29 healthy controls. For each patient, using the preoperative structural, diffusion, and postoperative structural MRI, we generated 2 networks: presurgery network and surgically spared network. Standardizing these networks with respect to controls, we determined the number of abnormal nodes before surgery and expected to be spared by surgery. We incorporated these 2 abnormality measures and 13 commonly acquired clinical data from each patient into a robust machine learning framework to estimate patient-specific chances of seizures persisting after surgery.

resultsPatients with more abnormal nodes had a lower chance of complete seizure freedom at 1 year and, even if seizure-free at 1 year, were more likely to relapse within 5 years. The number of abnormal nodes was greater and their locations more widespread in the surgically spared networks of patients with poor outcome than in patients with good outcome. We achieved an area under the curve of 0.84 ± 0.06 and specificity of 0.89 ± 0.09 in predicting unsuccessful seizure outcomes (International League Against Epilepsy [ILAE] 3-5) as opposed to complete seizure freedom (ILAE 1) at 1 year. Moreover, the model-predicted likelihood of seizure relapse was significantly correlated with the grade of surgical outcome at year 1 and associated with relapses up to 5 years after surgery.

conclusionNode abnormality offers a personalized, noninvasive marker that can be combined with clinical data to better estimate the chances of seizure freedom at 1 year and subsequent relapse up to 5 years after ATLR. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that node abnormality predicts postsurgical seizure recurrence.

Indexed as

Support Vector MachineAdultAnterior Temporal LobectomyBrainCase-Control StudiesDiffusion Magnetic Resonance ImagingDrug Resistant EpilepsyEpilepsy, Temporal LobeFemaleHumansMachine LearningMagnetic Resonance ImagingMaleMiddle AgedNeural PathwaysPostoperative Period

Identifiers

PMID33361262
PMCPMC7884990
OpenAlexW3115031811

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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.