title: Do neuroimaging results impact prognosis of epilepsy surgery? A meta-analysis.
abstract: The neuroimaging results of drug-resistant epilepsy patients play an important role in the surgery decision and prognosis. The aim of this study was to evaluate the impact of these results on the efficacy of epilepay surgery, and then to explore surgical benefit for epilepsy patients with negative magnetic resonance (MR) images. Twenty-four subgroups describing the outcomes of 1475 epilepsy patients with positive-neuroimaging results and 696 patients with negative-neuroimaging results were involved in the meta-analysis. Overall, the odds of postoperational seizure-free rate were 2.03 times higher in magnetic resonance imaging-positive (MRI-positive) patients than in MRI-negative patients [odds ratio (OR)=2.03, 95% CI (1.67, 2.47), P<0.00001]. For patients with temporal lobe epilepsy (TLE), the odds were 1.76 times higher in those with MRI-positive results than in those with MRI-negative results [OR=1.76, 95% CI (1.34, 2.32), P<0.0001]. For patients with extra-temporal lobe epilepsy (extra-TLE), the odds were 2.88 times higher in MRI-positive patients than in MRI-negative patients [OR=2.88, 95% CI (1.53, 5.43), P=0.001]. It was concluded that the seizure-free rate of MRI-positive patients after surgery was higher than that of MRI-negative patients. For patients with negative results, an appropriate surgery should be concerned for TLE.
authors.affiliation: Department of Neurology, Huazhong University of Science and Technology, Wuhan, 430030, China.
authors.forename: Zhuo-Ran
authors.initials: ZR
authors.lastname: Yin
authors.affiliation: Department of Neurology, Huazhong University of Science and Technology, Wuhan, 430030, China.
authors.forename: Hui-Cong
authors.initials: HC
authors.lastname: Kang
authors.affiliation: Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Wu
authors.affiliation: Department of Neurology, Huazhong University of Science and Technology, Wuhan, 430030, China.
authors.forename: Min
authors.initials: M
authors.lastname: Wang
authors.affiliation: Department of Neurology, Huazhong University of Science and Technology, Wuhan, 430030, China. zhusuiqiang@163.com.
authors.forename: Sui-Qiang
authors.initials: SQ
authors.lastname: Zhu
mesh_terms: D002681:China / Q000453:epidemiology; D004827:Epilepsy / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data*; D019635:Neurosurgical Procedures / Q000706:statistics & numerical data*; D015995:Prevalence; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D025321:Surgery, Computer-Assisted / Q000706:statistics & numerical data*; D016896:Treatment Outcome