ArticleEpilepsia2023
Epilepsy center characteristics and geographic region influence presurgical testing in the United States.
Article in Epilepsia, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 18 citations in OpenAlex.
- Magnetoencephalography (MEG) Augments Semiology in Stereotactic Electroencephalography (SEEG) Evaluations.Brain sciences · 2026Article
- Arterial spin labeling performs comparably to 2-[Epilepsia · 2026Article
- Performance of the 5-SENSE score in a pediatric and young adult cohort of 100 consecutive stereoelectroencephalography cases.Epilepsia · 2026Article
- A Review of Current Research and Barriers to Access: Exploring Disparities in Pediatric Epilepsy Surgery.Pediatric neurosurgery · 2026Review
- Single-Neuron Recordings Research in Children: Ethical Considerations, Feasibility, Technical Aspects, and Scientific Opportunities.Pediatric neurosurgery · 2026Review
- Achieving epilepsy care for all: Ecosystem-based transformation.Epilepsia · 2025Review
- Epilepsy clinic analytics: leveraging EMR reporting tools to characterize center volume and complexity.Frontiers in neurology · 2025Article
- Multifunctional hydrogel electronics for closed-loop antiepileptic treatment.Science advances · 2024Article
- Determinants of successful ictal SPECT injection in phase 1 epilepsy presurgical evaluation: Findings from the pediatric epilepsy research consortium surgery database project.Epilepsia open · 2024Article
- Post-processing of a distributed source method for the localization of somatosensory cortex in a cohort of epilepsy patients.Neuroimage. Reports · 2024Article
- Association Between Characteristics of National Association of Epilepsy Centers and Reported Utilization of Specific Surgical Techniques.Neurology · 2023Article
- Epilepsy center characteristics and geographic region influence presurgical testing in the United States.Epilepsia · 2023Article
Corrections and comments
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Authors and funding
16 authors at 12 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivePersons with drug-resistant epilepsy may benefit from epilepsy surgery and should undergo presurgical testing to determine potential candidacy and appropriate intervention. Institutional expertise can influence use and availability of evaluations and epilepsy surgery candidacy. This census survey study aims to examine the influence of geographic region and other center characteristics on presurgical testing for medically intractable epilepsy.
methodsWe analyzed annual report and supplemental survey data reported in 2020 from 206 adult epilepsy center directors and 136 pediatric epilepsy center directors in the United States. Test utilization data were compiled with annual center volumes, available resources, and US Census regional data. We used Wilcoxon rank-sum, Kruskal-Wallis, and chi-squared tests for univariate analysis of procedure utilization. Multivariable modeling was also performed to assign odds ratios (ORs) of significant variables.
resultsThe response rate was 100% with individual element missingness < 11% across 342 observations undergoing univariate analysis. A total of 278 complete observations were included in the multivariable models, and significant regional differences were present. For instance, compared to centers in the South, those in the Midwest used neuropsychological testing (OR = 2.87, 95% confidence interval [CI] = 1.2-6.86; p = .018) and fluorodeoxyglucose-positron emission tomography (OR = 2.74, 95% CI = = 1.14-6.61; p = .025) more commonly. For centers in the Northeast (OR = .46, 95% CI = .23-.93; p = .031) and West (OR = .41, 95% CI = .19-.87; p = .022), odds of performing single-photon emission computerized tomography were lower by nearly 50% compared to those in the South. Center accreditation level, demographics, volume, and resources were also associated with varying individual testing rates. SIGNIFICANCE: Presurgical testing for drug-resistant epilepsy is influenced by US geographic region and other center characteristics. These findings have potential implications for comparing outcomes between US epilepsy centers and may inject disparities in access to surgical treatment.
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