ArticleEpilepsia open2021
The epileptogenic zone in children with tuberous sclerosis complex is characterized by prominent features of focal cortical dysplasia.
Article in Epilepsia open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 20 citations in OpenAlex.
- Cortical Tubers' Transformation in Pediatric Patients Diagnosed with Tuberous Sclerosis Complex: A Retrospective Longitudinal MRI Analysis.Journal of clinical medicine · 2025Article
- A comparative analysis of imaging-based algorithms for detecting focal cortical dysplasia type II in children.Scientific reports · 2025Article
- Diagnostic accuracy of T2-hypointensity in determining the epileptogenic lesion on unmyelinated brain MRI in infants with tuberous sclerosis complex (TSC).Brain communications · 2025Article
- Single unit-derived connectivity networks in tuberous sclerosis complex reveal propensity for network hypersynchrony driven by tuber-tuber interactions.Scientific reports · 2024Article
- Morphological Features of Language Regions in Individuals with Tuberous Sclerosis Complex.Journal of autism and developmental disorders · 2024Article
- Predicting Drug Treatment Outcomes in Childrens with Tuberous Sclerosis Complex-Related Epilepsy: A Clinical Radiomics Study.AJNR. American journal of neuroradiology · 2023Article
- Article
- Perianaesthetic challenges in patients undergoing vagus nerve stimulation (VNS) placement.BMJ case reports · 2023Article
- Limited utility of structural MRI to identify the epileptogenic zone in young children with tuberous sclerosis.Journal of neuroimaging : official journal of the American Society of Neuroimaging · 2022Article
- Commentary on "The epileptogenic zone in children with tuberous sclerosis complex is characterized by prominent features of focal cortical dysplasia".Epilepsia open · 2022Article
- The epileptogenic zone in children with tuberous sclerosis complex is characterized by prominent features of focal cortical dysplasia.Epilepsia open · 2021Article
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Authors and funding
9 authors at 3 institutions in 2 countries.
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No grant is acknowledged in the PubMed record.
Abstract
objectivePatients with tuberous sclerosis complex (TSC) present with drug-resistant epilepsy in about 60% of cases, and evaluation for epilepsy surgery may be warranted. Correct delineation of the epileptogenic zone (EZ) among multiple dysplastic lesions on MRI represents a challenging step in pre-surgical evaluation.
methodsTwo experienced neuroradiologists evaluated pre- and post-surgical MRIs of 28 epilepsy surgery patients with TSC, assessing characteristics of tubers, cysts, calcifications, and focal cortical dysplasia (FCD)-resembling lesions. Utilizing multiple metrics, we compared MRI features of the EZ-defined as the resected area in TSC patients who achieved seizure-freedom 2 years after epilepsy surgery-with features of other brain areas. Using combinatorial analysis, we identified combinations of dysplastic features that are most frequently observed in the epileptogenic zone in TSC patients.
resultsAll TSC-associated dysplastic features were more frequently observed in the EZ than in other brain areas (increased cortical thickness, gray-white matter blurring, transmantle sign, calcifications, and tubers; Kendal's tau 0.35, 0.25, 0.27, 0.26, and 0.23, respectively; P value <.001 in all). No single feature could reliably and independently indicate the EZ in all patients. Conversely, the EZ was indicated by the presence of the combination of three of the following features: tubers, transmantle sign, increased cortical thickness, calcifications, and the largest FCD-affected area. Out of these, the largest FCD-affected area emerged as the most reliable indicator of the EZ, combined either with calcifications or tubers. SIGNIFICANCE: The epileptogenic zone in TSC patients harbors multiple dysplastic features, consistent with focal cortical dysplasia. A specific combination of these features can indicate the EZ and aid in pre-surgical MRI evaluation in epilepsy surgery candidates with TSC.
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