Evidence map›Paper›PMID 37547655›Full record

ArticleArXiv2023

Quantifying interictal intracranial EEG to predict focal epilepsy.

Ryan S Gallagher, Nishant Sinha, Akash R Pattnaik, William K S Ojemann, Alfredo Lucas, Joshua J LaRocque, John M Bernabei, Adam S Greenblatt, Elizabeth M Sweeney, H Isaac Chen and 3 more

Open access · greenAbstract readPreprint
In one paragraph

Article in ArXiv, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–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

0 citing papers in PubMed, 0 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 1 institution in 1 country.

Ryan S GallagherCenter for Neuroengineering and Therapeutics, University of Pennsylvania.
Nishant SinhaCenter for Neuroengineering and Therapeutics, University of Pennsylvania.
Akash R PattnaikCenter for Neuroengineering and Therapeutics, University of Pennsylvania.
William K S OjemannCenter for Neuroengineering and Therapeutics, University of Pennsylvania.
Alfredo LucasCenter for Neuroengineering and Therapeutics, University of Pennsylvania.
Joshua J LaRocqueCenter for Neuroengineering and Therapeutics, University of Pennsylvania.
John M BernabeiCenter for Neuroengineering and Therapeutics, University of Pennsylvania.
Adam S GreenblattDepartment of Neurology, University of Pennsylvania.
Elizabeth M SweeneyDepartment of Biostatistics, Epidemiology and Informatics, University of Pennsylvania.
H Isaac ChenDepartment of Neurosurgery, University of Pennsylvania.
Kathryn A DavisCenter for Neuroengineering and Therapeutics, University of Pennsylvania.
Erin C ConradCenter for Neuroengineering and Therapeutics, University of Pennsylvania.
Brian LittCenter for Neuroengineering and Therapeutics, University of Pennsylvania.
University of Pennsylvania · US

Funding

Ghost in the Machine: Melding Brain, Computer and BehaviorDP1NS122038 · NINDS · UNIVERSITY OF PENNSYLVANIA · PI LITT, BRIAN · 2020 to 2024
$5.7M
Training Program in Neuroengineering and MedicineT32NS091006 · NINDS · UNIVERSITY OF PENNSYLVANIA · PI Brian Litt · 2015 to 2026
$4.1M
Optimized Intracranial EEG Targeting in Focal Epilepsy based upon Neuroimaging ConnectomicsR01NS116504 · NINDS · UNIVERSITY OF PENNSYLVANIA · PI DAVIS, KATHRYN ADAMIAK · 2021 to 2025
$3.3M
Research Training Program in Disease Oriented Neuroscience (R25)R25NS065745 · NINDS · UNIVERSITY OF PENNSYLVANIA · PI DETRE, JOHN A · 2009 to 2023
$3.0M
Guiding epilepsy surgery using network models and Stereo EEGR01NS125137 · NINDS · UNIVERSITY OF PENNSYLVANIA · PI BASSETT, DANIELLE SMITH, LITT, BRIAN · 2022 to 2025
$2.8M
Quantitative interictal networks to localize seizure generatorsK23NS121401 · NINDS · UNIVERSITY OF PENNSYLVANIA · PI Erin Conrad · 2022 to 2026
$1.2M
NINDS NIH HHS DP1 NS122038NINDS NIH HHS K23 NS121401NINDS NIH HHS R01 NS116504NINDS NIH HHS R01 NS125137NINDS NIH HHS R25 NS065745NINDS NIH HHS T32 NS091006
6 · The paper itself

Abstract

Introduction: Intracranial EEG (IEEG) is used for 2 main purposes, to determine: (1) if epileptic networks are amenable to focal treatment and (2) where to intervene. Currently these questions are answered qualitatively and sometimes differently across centers. There is a need for objective, standardized methods to guide surgical decision making and to enable large scale data analysis across centers and prospective clinical trials. Methods: We analyzed interictal data from 101 patients with drug resistant epilepsy who underwent presurgical evaluation with IEEG. We chose interictal data because of its potential to reduce the morbidity and cost associated with ictal recording. 65 patients had unifocal seizure onset on IEEG, and 36 were non-focal or multi-focal. We quantified the spatial dispersion of implanted electrodes and interictal IEEG abnormalities for each patient. We compared these measures against the "5 Sense Score (5SS)," a pre-implant estimate of the likelihood of focal seizure onset, and assessed their ability to predict the clinicians' choice of therapeutic intervention and the patient outcome. Results: The spatial dispersion of IEEG electrodes predicted network focality with precision similar to the 5SS (AUC = 0.67), indicating that electrode placement accurately reflected pre-implant information. A cross-validated model combining the 5SS and the spatial dispersion of interictal IEEG abnormalities significantly improved this prediction (AUC = 0.79; p<0.05). The combined model predicted ultimate treatment strategy (surgery vs. device) with an AUC of 0.81 and post-surgical outcome at 2 years with an AUC of 0.70. The 5SS, interictal IEEG, and electrode placement were not correlated and provided complementary information. Conclusions: Quantitative, interictal IEEG significantly improved upon pre-implant estimates of network focality and predicted treatment with precision approaching that of clinical experts. We present this study as an important step in building standardized, quantitative tools to guide epilepsy surgery.

Indexed as

epilepsy surgeryintracranial EEGnormative atlasseizure onset zonespatial coverage

Identifiers

PMID37547655
PMCPMC10402195
OpenAlexW4385620748

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.