Predicting Surgery Targets in Temporal Lobe Epilepsy through Structural Connectome Based Simulations
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- Olaf Sporns
- editor
書誌事項
- 公開日
- 2015-12-10
- 権利情報
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- http://creativecommons.org/licenses/by/4.0/
- DOI
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- 10.1371/journal.pcbi.1004642
- 公開者
- Public Library of Science (PLoS)
説明
Temporal lobe epilepsy (TLE) is a prevalent neurological disorder resulting in disruptive seizures. In the case of drug resistant epilepsy resective surgery is often considered. This is a procedure hampered by unpredictable success rates, with many patients continuing to have seizures even after surgery. In this study we apply a computational model of epilepsy to patient specific structural connectivity derived from diffusion tensor imaging (DTI) of 22 individuals with left TLE and 39 healthy controls. We validate the model by examining patient-control differences in simulated seizure onset time and network location. We then investigate the potential of the model for surgery prediction by performing in silico surgical resections, removing nodes from patient networks and comparing seizure likelihood post-surgery to pre-surgery simulations. We find that, first, patients tend to transit from non-epileptic to epileptic states more often than controls in the model. Second, regions in the left hemisphere (particularly within temporal and subcortical regions) that are known to be involved in TLE are the most frequent starting points for seizures in patients in the model. In addition, our analysis also implicates regions in the contralateral and frontal locations which may play a role in seizure spreading or surgery resistance. Finally, the model predicts that patient-specific surgery (resection areas chosen on an individual, model-prompted, basis and not following a predefined procedure) may lead to better outcomes than the currently used routine clinical procedure. Taken together this work provides a first step towards patient specific computational modelling of epilepsy surgery in order to inform treatment strategies in individuals.
収録刊行物
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- PLOS Computational Biology
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PLOS Computational Biology 11 (12), e1004642-, 2015-12-10
Public Library of Science (PLoS)
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キーワード
- Adult
- Male
- Models, Anatomic
- Patient-Specific Modeling
- QH301-705.5
- Models, Neurological
- Hippocampus
- Monitoring, Intraoperative
- Preoperative Care
- Connectome
- Humans
- Computer Simulation
- Biology (General)
- Aged
- Middle Aged
- Neurophysiological Monitoring
- Diffusion Tensor Imaging
- Treatment Outcome
- Epilepsy, Temporal Lobe
- Surgery, Computer-Assisted
- Female
- Research Article