title: Localizing seizure-susceptible brain regions associated with low-grade gliomas using voxel-based lesion-symptom mapping.
abstract: BACKGROUND
  Patients afflicted with low-grade glioma (LGG) frequently suffer from seizures. The mechanisms of seizure initiation in these patients remain poorly understood. Tumor location has been correlated with seizure initiation. However, these correlative studies relied on dichotomized data analysis based on arbitrary lobe assignments. As a result, the lesion-symptom correlation may be incorrectly interpreted. Here, we present the first study that used a voxel-wise quantitative lesion analysis to investigate the spatial correlation between tumor location and seizure susceptibility.
  
  
  METHODS
  We collected the medical records and magnetic resonance images of 410 LGG patients. The dataset was divided into a discovery set and a validation set. A voxel-based lesion-symptom correlative analysis was performed to determine whether tumor location was associated with seizure risk and could be related to the specific type of seizure.
  
  
  RESULTS
  For all seizure types, increased seizure risks were identified for LGGs that involved the left premotor area. The LGGs that involved the posterior portion of the left inferior and middle frontal gyrus were associated with increased risk of simple partial seizures. LGGs that involved the right temporal-insular region were associated with an increased risk of complex partial seizures. LGGs that involved the left premotor area were more likely to be associated with seizures that generalize. These correlations were consistently observed in both the discovery and the validation datasets.
  
  
  CONCLUSIONS
  Our quantitative neuroimaging analyses support the concept that the anatomic location of an LGG is a contributing factor in tumor-related seizure.
authors.affiliation: Beijing Neurosurgical Institute, Capital Medical University, Beijing, China (Y.W., T.J.); Department of Neurosurgery (Y.W., G.Y., T.J.); Department of Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China (J.M.); Siemens Healthcare, MR Collaboration NE Asia, Beijing, China (T.Q.); Department of Epidemiology and Biostatistics, School of Public Health and Family Medicine, Capital Medical University, Beijing, China (X.P.); Department of Neurosurgery (C.C.); Department of Pediatric Neurology, University of California, San Diego, California (S.W.); Department of Neurosurgery, Nanjing Medical University, The First Affiliated Hospital, Nanjing, China (Y.Y.); Department of Neurosurgery, Beijing Sanbo Hospital, Capital Medical University, Beijing, China (K.Y., C.W.); Department of Neurology, Medical School, University of Minnesota, Minneapolis, Minnesota (Z.S.).
authors.forename: Yinyan
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Beijing Neurosurgical Institute, Capital Medical University, Beijing, China (Y.W., T.J.); Department of Neurosurgery (Y.W., G.Y., T.J.); Department of Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China (J.M.); Siemens Healthcare, MR Collaboration NE Asia, Beijing, China (T.Q.); Department of Epidemiology and Biostatistics, School of Public Health and Family Medicine, Capital Medical University, Beijing, China (X.P.); Department of Neurosurgery (C.C.); Department of Pediatric Neurology, University of California, San Diego, California (S.W.); Department of Neurosurgery, Nanjing Medical University, The First Affiliated Hospital, Nanjing, China (Y.Y.); Department of Neurosurgery, Beijing Sanbo Hospital, Capital Medical University, Beijing, China (K.Y., C.W.); Department of Neurology, Medical School, University of Minnesota, Minneapolis, Minnesota (Z.S.).
authors.forename: Tianyi
authors.initials: T
authors.lastname: Qian
authors.affiliation: Beijing Neurosurgical Institute, Capital Medical University, Beijing, China (Y.W., T.J.); Department of Neurosurgery (Y.W., G.Y., T.J.); Department of Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China (J.M.); Siemens Healthcare, MR Collaboration NE Asia, Beijing, China (T.Q.); Department of Epidemiology and Biostatistics, School of Public Health and Family Medicine, Capital Medical University, Beijing, China (X.P.); Department of Neurosurgery (C.C.); Department of Pediatric Neurology, University of California, San Diego, California (S.W.); Department of Neurosurgery, Nanjing Medical University, The First Affiliated Hospital, Nanjing, China (Y.Y.); Department of Neurosurgery, Beijing Sanbo Hospital, Capital Medical University, Beijing, China (K.Y., C.W.); Department of Neurology, Medical School, University of Minnesota, Minneapolis, Minnesota (Z.S.).
authors.forename: Gan
authors.initials: G
authors.lastname: You
authors.affiliation: Beijing Neurosurgical Institute, Capital Medical University, Beijing, China (Y.W., T.J.); Department of Neurosurgery (Y.W., G.Y., T.J.); Department of Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China (J.M.); Siemens Healthcare, MR Collaboration NE Asia, Beijing, China (T.Q.); Department of Epidemiology and Biostatistics, School of Public Health and Family Medicine, Capital Medical University, Beijing, China (X.P.); Department of Neurosurgery (C.C.); Department of Pediatric Neurology, University of California, San Diego, California (S.W.); Department of Neurosurgery, Nanjing Medical University, The First Affiliated Hospital, Nanjing, China (Y.Y.); Department of Neurosurgery, Beijing Sanbo Hospital, Capital Medical University, Beijing, China (K.Y., C.W.); Department of Neurology, Medical School, University of Minnesota, Minneapolis, Minnesota (Z.S.).
authors.forename: Xiaoxia
authors.initials: X
authors.lastname: Peng
authors.affiliation: Beijing Neurosurgical Institute, Capital Medical University, Beijing, China (Y.W., T.J.); Department of Neurosurgery (Y.W., G.Y., T.J.); Department of Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China (J.M.); Siemens Healthcare, MR Collaboration NE Asia, Beijing, China (T.Q.); Department of Epidemiology and Biostatistics, School of Public Health and Family Medicine, Capital Medical University, Beijing, China (X.P.); Department of Neurosurgery (C.C.); Department of Pediatric Neurology, University of California, San Diego, California (S.W.); Department of Neurosurgery, Nanjing Medical University, The First Affiliated Hospital, Nanjing, China (Y.Y.); Department of Neurosurgery, Beijing Sanbo Hospital, Capital Medical University, Beijing, China (K.Y., C.W.); Department of Neurology, Medical School, University of Minnesota, Minneapolis, Minnesota (Z.S.).
authors.forename: Clark
authors.initials: C
authors.lastname: Chen
authors.affiliation: Beijing Neurosurgical Institute, Capital Medical University, Beijing, China (Y.W., T.J.); Department of Neurosurgery (Y.W., G.Y., T.J.); Department of Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China (J.M.); Siemens Healthcare, MR Collaboration NE Asia, Beijing, China (T.Q.); Department of Epidemiology and Biostatistics, School of Public Health and Family Medicine, Capital Medical University, Beijing, China (X.P.); Department of Neurosurgery (C.C.); Department of Pediatric Neurology, University of California, San Diego, California (S.W.); Department of Neurosurgery, Nanjing Medical University, The First Affiliated Hospital, Nanjing, China (Y.Y.); Department of Neurosurgery, Beijing Sanbo Hospital, Capital Medical University, Beijing, China (K.Y., C.W.); Department of Neurology, Medical School, University of Minnesota, Minneapolis, Minnesota (Z.S.).
authors.forename: Yongping
authors.initials: Y
authors.lastname: You
authors.affiliation: Beijing Neurosurgical Institute, Capital Medical University, Beijing, China (Y.W., T.J.); Department of Neurosurgery (Y.W., G.Y., T.J.); Department of Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China (J.M.); Siemens Healthcare, MR Collaboration NE Asia, Beijing, China (T.Q.); Department of Epidemiology and Biostatistics, School of Public Health and Family Medicine, Capital Medical University, Beijing, China (X.P.); Department of Neurosurgery (C.C.); Department of Pediatric Neurology, University of California, San Diego, California (S.W.); Department of Neurosurgery, Nanjing Medical University, The First Affiliated Hospital, Nanjing, China (Y.Y.); Department of Neurosurgery, Beijing Sanbo Hospital, Capital Medical University, Beijing, China (K.Y., C.W.); Department of Neurology, Medical School, University of Minnesota, Minneapolis, Minnesota (Z.S.).
authors.forename: Kun
authors.initials: K
authors.lastname: Yao
authors.affiliation: Beijing Neurosurgical Institute, Capital Medical University, Beijing, China (Y.W., T.J.); Department of Neurosurgery (Y.W., G.Y., T.J.); Department of Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China (J.M.); Siemens Healthcare, MR Collaboration NE Asia, Beijing, China (T.Q.); Department of Epidemiology and Biostatistics, School of Public Health and Family Medicine, Capital Medical University, Beijing, China (X.P.); Department of Neurosurgery (C.C.); Department of Pediatric Neurology, University of California, San Diego, California (S.W.); Department of Neurosurgery, Nanjing Medical University, The First Affiliated Hospital, Nanjing, China (Y.Y.); Department of Neurosurgery, Beijing Sanbo Hospital, Capital Medical University, Beijing, China (K.Y., C.W.); Department of Neurology, Medical School, University of Minnesota, Minneapolis, Minnesota (Z.S.).
authors.forename: Chenxing
authors.initials: C
authors.lastname: Wu
authors.affiliation: Beijing Neurosurgical Institute, Capital Medical University, Beijing, China (Y.W., T.J.); Department of Neurosurgery (Y.W., G.Y., T.J.); Department of Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China (J.M.); Siemens Healthcare, MR Collaboration NE Asia, Beijing, China (T.Q.); Department of Epidemiology and Biostatistics, School of Public Health and Family Medicine, Capital Medical University, Beijing, China (X.P.); Department of Neurosurgery (C.C.); Department of Pediatric Neurology, University of California, San Diego, California (S.W.); Department of Neurosurgery, Nanjing Medical University, The First Affiliated Hospital, Nanjing, China (Y.Y.); Department of Neurosurgery, Beijing Sanbo Hospital, Capital Medical University, Beijing, China (K.Y., C.W.); Department of Neurology, Medical School, University of Minnesota, Minneapolis, Minnesota (Z.S.).
authors.forename: Jun
authors.initials: J
authors.lastname: Ma
authors.affiliation: Beijing Neurosurgical Institute, Capital Medical University, Beijing, China (Y.W., T.J.); Department of Neurosurgery (Y.W., G.Y., T.J.); Department of Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China (J.M.); Siemens Healthcare, MR Collaboration NE Asia, Beijing, China (T.Q.); Department of Epidemiology and Biostatistics, School of Public Health and Family Medicine, Capital Medical University, Beijing, China (X.P.); Department of Neurosurgery (C.C.); Department of Pediatric Neurology, University of California, San Diego, California (S.W.); Department of Neurosurgery, Nanjing Medical University, The First Affiliated Hospital, Nanjing, China (Y.Y.); Department of Neurosurgery, Beijing Sanbo Hospital, Capital Medical University, Beijing, China (K.Y., C.W.); Department of Neurology, Medical School, University of Minnesota, Minneapolis, Minnesota (Z.S.).
authors.forename: Zhiyi
authors.initials: Z
authors.lastname: Sha
authors.affiliation: Beijing Neurosurgical Institute, Capital Medical University, Beijing, China (Y.W., T.J.); Department of Neurosurgery (Y.W., G.Y., T.J.); Department of Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China (J.M.); Siemens Healthcare, MR Collaboration NE Asia, Beijing, China (T.Q.); Department of Epidemiology and Biostatistics, School of Public Health and Family Medicine, Capital Medical University, Beijing, China (X.P.); Department of Neurosurgery (C.C.); Department of Pediatric Neurology, University of California, San Diego, California (S.W.); Department of Neurosurgery, Nanjing Medical University, The First Affiliated Hospital, Nanjing, China (Y.Y.); Department of Neurosurgery, Beijing Sanbo Hospital, Capital Medical University, Beijing, China (K.Y., C.W.); Department of Neurology, Medical School, University of Minnesota, Minneapolis, Minnesota (Z.S.).
authors.forename: Sonya
authors.initials: S
authors.lastname: Wang
authors.affiliation: Beijing Neurosurgical Institute, Capital Medical University, Beijing, China (Y.W., T.J.); Department of Neurosurgery (Y.W., G.Y., T.J.); Department of Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China (J.M.); Siemens Healthcare, MR Collaboration NE Asia, Beijing, China (T.Q.); Department of Epidemiology and Biostatistics, School of Public Health and Family Medicine, Capital Medical University, Beijing, China (X.P.); Department of Neurosurgery (C.C.); Department of Pediatric Neurology, University of California, San Diego, California (S.W.); Department of Neurosurgery, Nanjing Medical University, The First Affiliated Hospital, Nanjing, China (Y.Y.); Department of Neurosurgery, Beijing Sanbo Hospital, Capital Medical University, Beijing, China (K.Y., C.W.); Department of Neurology, Medical School, University of Minnesota, Minneapolis, Minnesota (Z.S.).
authors.forename: Tao
authors.initials: T
authors.lastname: Jiang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001921:Brain / Q000473:pathology* / Q000503:physiopathology*; D001931:Brain Mapping / Q000379:methods; D001932:Brain Neoplasms / Q000145:classification / Q000150:complications* / Q000473:pathology*; D005260:Female; D005910:Glioma / Q000145:classification / Q000150:complications* / Q000473:pathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012640:Seizures / Q000209:etiology*; D055815:Young Adult
keywords: lesion-symptom mapping; low-grade glioma; seizure