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The impact of temporal lobe epilepsy surgery on picture naming and its relationship to network metric change.
Peter Binding, Lawrence; Neal Taylor, Peter; O'Keeffe, Aidan G; Giampiccolo, Davide; Fleury, Marine; Xiao, Fenglai; Caciagli, Lorenzo; de Tisi, Jane; Winston, Gavin P; Miserocchi, Anna; McEvoy, Andrew; Duncan, John S; Vos, Sjoerd B.
Afiliación
  • Peter Binding L; Centre for Medical Image Computing, Department of Computer Science, UCL, London, United Kingdom; Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, United Kingdom. Electronic address: lawrence.binding.19@ucl.ac.uk.
  • Neal Taylor P; Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, United Kingdom; CNNP lab, Interdisciplinary Computing and Complex BioSystems Group, School of Computing Science, Newcastle University, United Kingdom.
  • O'Keeffe AG; School of Mathematical Sciences, University of Nottingham, United Kingdom; Institute of Epidemiology and Healthcare, UCL, London WC1E 6BT, United Kingdom.
  • Giampiccolo D; Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, United Kingdom; Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom; Department of Neurosurgery, Institute of Neurosciences
  • Fleury M; Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, United Kingdom.
  • Xiao F; Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, United Kingdom; MRI Unit, Chalfont Centre for Epilepsy, Chalfont St Peter, United Kingdom.
  • Caciagli L; MRI Unit, Chalfont Centre for Epilepsy, Chalfont St Peter, United Kingdom; Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, United Kingdom.
  • de Tisi J; MRI Unit, Chalfont Centre for Epilepsy, Chalfont St Peter, United Kingdom.
  • Winston GP; Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, United Kingdom; MRI Unit, Chalfont Centre for Epilepsy, Chalfont St Peter, United Kingdom; Department of Medicine, Division of Neurology, Queens University, Kingston, Canada.
  • Miserocchi A; Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, United Kingdom; Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom.
  • McEvoy A; Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, United Kingdom; Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom.
  • Duncan JS; Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, United Kingdom; MRI Unit, Chalfont Centre for Epilepsy, Chalfont St Peter, United Kingdom.
  • Vos SB; Centre for Medical Image Computing, Department of Computer Science, UCL, London, United Kingdom; Neuroradiological Academic Unit, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom; Centre for Microscopy, Characterisation, and Analysis, The University of Weste
Neuroimage Clin ; 38: 103444, 2023.
Article en En | MEDLINE | ID: mdl-37300974
ABSTRACT

BACKGROUND:

Anterior temporal lobe resection (ATLR) is a successful treatment for medically-refractory temporal lobe epilepsy (TLE). In the language-dominant hemisphere, 30%- 50% of individuals experience a naming decline which can impact upon daily life. Measures of structural networks are associated with language performance pre-operatively. It is unclear if analysis of network measures may predict post-operative decline.

METHODS:

White matter fibre tractography was performed on preoperative diffusion MRI of 44 left lateralised and left resection individuals with TLE to reconstruct the preoperative structural network. Resection masks, drawn on co-registered pre- and post-operative T1-weighted MRI scans, were used as exclusion regions on pre-operative tractography to estimate the post-operative network. Changes in graph theory metrics, cortical strength, betweenness centrality, and clustering coefficient were generated by comparing the estimated pre- and post-operative networks. These were thresholded based on the presence of the connection in each patient, ranging from 75% to 100% in steps of 5%. The average graph theory metric across thresholds was taken. We incorporated leave-one-out cross-validation with smoothly clipped absolute deviation (SCAD) least absolute shrinkage and selection operator (LASSO) feature selection and a support vector classifier to assess graph theory metrics on picture naming decline. Picture naming was assessed via the Graded Naming Test preoperatively and at 3 and 12 months post-operatively and the outcome was classified using the reliable change index (RCI) to identify clinically significant decline. The best feature combination and model was selected using the area under the curve (AUC). The sensitivity, specificity and F1-score were also reported. Permutation testing was performed to assess the machine learning model and selected regions difference significance.

RESULTS:

A combination of clinical and graph theory metrics were able to classify outcome of picture naming at 3 months with an AUC of 0.84. At 12 months, change in strength to cortical regions was best able to correctly classify outcome with an AUC of 0.86. Longitudinal analysis revealed that betweenness centrality was the best metric to identify patients who declined at 3 months, who will then continue to experience decline from 3 to 12 months. Both models were significantly higher AUC values than a random classifier.

CONCLUSION:

Our results suggest that inferred changes of network integrity were able to correctly classify picture naming decline after ATLR. These measures may be used to prospectively to identify patients who are at risk of picture naming decline after surgery and could potentially be utilised to assist tailoring the resection in order to prevent this decline.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Epilepsia del Lóbulo Temporal / Trastornos del Lenguaje Tipo de estudio: Prognostic_studies Límite: Humans Idioma: En Revista: Neuroimage Clin Año: 2023 Tipo del documento: Article

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Epilepsia del Lóbulo Temporal / Trastornos del Lenguaje Tipo de estudio: Prognostic_studies Límite: Humans Idioma: En Revista: Neuroimage Clin Año: 2023 Tipo del documento: Article