title: Predicting outcome of anterior temporal lobectomy using simulated neural networks.
abstract: OBJECTIVE
  Anterior temporal lobectomy (ATL) is an important option for treatment of medically refractory seizures. Patient selection is not always clear-cut, and there is inherent morbidity and mortality associated with the invasive and expensive surgical protocols. To determine whether patient selection might be facilitated by application of artificial intelligence, we developed a model that predicted seizure outcome after ATL, using a simulated neural network (SNN).
  
  
  METHODS
  Predictions of the model were compared with predictions derived from conventional discriminant function analysis. Neural networks and discriminant functions were devised that would predict the occurrence of both Class 1 outcomes (totally seizure-free), and Class 1 or Class 2 outcomes (nearly or totally seizure-free), using data from 87 patients from three surgical centers. The SNNs and discriminant functions were developed using data from a randomly selected subsample of 65 patients, and both models were cross-validated, using the remaining 22 patients.
  
  
  RESULTS
  The discriminant functions showed overall predictive accuracy of 78.5% and 72.7%, while the neural networks demonstrated overall accuracy of 81.8% and 95.4%.
  
  
  CONCLUSIONS
  Simulated neural networks show promise as adjuncts to decision-making in the selection of epilepsy surgery patients.
authors.affiliation: University of Colorado Health Sciences Center, Denver 80222, USA.
authors.forename: J
authors.initials: J
authors.lastname: Grigsby
authors.forename: R E
authors.initials: RE
authors.lastname: Kramer
authors.forename: J L
authors.initials: JL
authors.lastname: Schneiders
authors.forename: J R
authors.initials: JR
authors.lastname: Gates
authors.forename: W
authors.initials: W
authors.lastname: Brewster Smith
mesh_terms: D000293:Adolescent; D000328:Adult; D016002:Discriminant Analysis; D004569:Electroencephalography; D004827:Epilepsy / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D007839:Functional Laterality; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D016571:Neural Networks, Computer; D011379:Prognosis; D012189:Retrospective Studies; D003294:Seizures, Febrile / Q000601:surgery; D013702:Temporal Lobe / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome