SynthesisEpilepsia2025
MRI-negative epilepsy: A systematic review and meta-analysis.
Synthesis in Epilepsia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- MRI-negative epilepsy: A systematic review and meta-analysis.Epilepsia · 2025Pooled it
- Quantifying extra-lesional interhemispheric cortical asymmetry in focal cortical dysplasia type II.Epilepsia open · 2026Article
- Quantitative dual-tracerEuropean journal of nuclear medicine and molecular imaging · 2026Article
- Enhanced detection of subtle cortical abnormalities in focal epilepsy using 7 T MRI surface-based models and graph neural networks.Neuroradiology · 2026Article
- Initial negative imaging in GATOR1-associated genetic epilepsy does not preclude the existence of a focal, resectable epileptogenic zone: illustrative cases.Journal of neurosurgery. Case lessons · 2026Article
- Review
- Optimizing the diagnostic timing for drug-resistant epilepsy: balancing timeliness and stability with an antiseizure medication waiting period.Therapeutic advances in neurological disorders · 2026Article
- MRI derived hippocampal asymmetry identifies hippocampal sclerosis in epilepsy surgical specimens.Brain communications · 2026Article
- Twenty years of frontal lobe surgery: Clinical outcomes and lessons from the frontier.Surgical neurology international · 2026Article
- Subtle Hippocampal Subfield Volumetric Alterations in Clinically Diagnosed MRI-Negative Temporal Lobe Epilepsy.Noro psikiyatri arsivi · 2026Article
- Network dysfunction underlying verbal fluency deficits in newly diagnosed epilepsy: a resting-state fMRI functional connectivity study.BMC medicine · 2025Article
- Circumstantial, but Compelling: Multimodal Phase 1 Data and the Seizure Onset Zone.Epilepsy currentsArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
objectiveDrug-resistant focal epilepsy is commonly dichotomized based on magnetic resonance imaging (MRI) lesion visibility into positive (MRI-pos) and negative (MRI-neg). Yet, the criteria used to ascribe such categorization are variable. We used a systematic review and meta-analysis to synthesize evidence for the designation of MRI-neg status.
methodsIn accordance with Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, the systematic review (1990-2025) across Embase, Cochrane, and Medline databases identified cohorts with MRI-neg epilepsy. Unsupervised clustering stratified studies based on co-occurrence of imaging modalities. Within identified classes, we assessed the consistency of reporting MRI parameters, rater expertise, post-processing, and stereo-electroencephalography (SEEG). Meta-analyses evaluated the effects of post-processing on diagnostic yield and MRI-neg status on post-surgical outcome.
resultsWe screened 2622 records and assessed the eligibility of 448 full-text articles, 246 of which met the inclusion criteria for systematic review: 108 (44%) provided data only on MRI-neg and 138 (56%) on mixed adult cohorts, for a total of 10.463 MRI-neg and 7436 MRI-pos patients. Compared to MRI-pos, MRI-neg patients underwent SEEG more frequently (75% vs 54%, p < 0.05), underwent surgery less frequently (73% vs 84%; odds ratio [OR] = 1.14, p < 0.001), and had less favorable outcomes (61% vs 72%, p < 0.05). Clustering identified three classes: MRI-dominant, typified by consistent reporting of MRI parameters (ORs >3.11, p < 0.001), rater-expertise (ORs >9.94, p < 0.001), and post-processing (ORs >3.38, p < 0.03), as opposed to Limited-MRI (χ SIGNIFICANCE: The designation of MRI-neg is ambiguous, with most studies lacking details on imaging parameters and reader expertise. Given a 39% gain in diagnostic yield, MRI post-processing should be performed systematically as part of a modern multimodal approach to epilepsy surgery before ascribing MRI-neg status.
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Registered trials
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.