title: The brain connectome as a personalized biomarker of seizure outcomes after temporal lobectomy.
abstract: OBJECTIVE
  We examined whether individual neuronal architecture obtained from the brain connectome can be used to estimate the surgical success of anterior temporal lobectomy (ATL) in patients with temporal lobe epilepsy (TLE).
  
  
  METHODS
  We retrospectively studied 35 consecutive patients with TLE who underwent ATL. The structural brain connectome was reconstructed from all patients using presurgical diffusion MRI. Network links in patients were standardized as Z scores based on connectomes reconstructed from healthy controls. The topography of abnormalities in linkwise elements of the connectome was assessed on subnetworks linking ipsilateral temporal with extratemporal regions. Predictive models were constructed based on the individual prevalence of linkwise Z scores >2 and based on presurgical clinical data.
  
  
  RESULTS
  Patients were more likely to achieve postsurgical seizure freedom if they exhibited fewer abnormalities within a subnetwork composed of the ipsilateral hippocampus, amygdala, thalamus, superior frontal region, lateral temporal gyri, insula, orbitofrontal cortex, cingulate, and lateral occipital gyrus. Seizure-free surgical outcome was predicted by neural architecture alone with 90% specificity (83% accuracy), and by neural architecture combined with clinical data with 94% specificity (88% accuracy).
  
  
  CONCLUSIONS
  Individual variations in connectome topography, combined with presurgical clinical data, may be used as biomarkers to better estimate surgical outcomes in patients with TLE.
authors: From the Departments of Neurology (L.B., J.H.J., J.B., T.N.), Radiology and Radiological Science (J.H.J.), and Public Health Sciences (N.B.), Medical University of South Carolina, Charleston; the Department of Neurology (J.J.L.), University of California Irvine; the Departments of Neurology and Pediatrics (D.L.D.) and Radiology (A.M.S.), Emory University, Atlanta, GA; the Department of Neurology (J.R.B.), Medical College of Wisconsin, Milwaukee; and the Comprehensive Epilepsy Center (R.I.K.), New York University, New York. bonilha@musc.edu.
authors: Leonardo
authors: L
authors: Bonilha
authors: From the Departments of Neurology (L.B., J.H.J., J.B., T.N.), Radiology and Radiological Science (J.H.J.), and Public Health Sciences (N.B.), Medical University of South Carolina, Charleston; the Department of Neurology (J.J.L.), University of California Irvine; the Departments of Neurology and Pediatrics (D.L.D.) and Radiology (A.M.S.), Emory University, Atlanta, GA; the Department of Neurology (J.R.B.), Medical College of Wisconsin, Milwaukee; and the Comprehensive Epilepsy Center (R.I.K.), New York University, New York.
authors: Jens H
authors: JH
authors: Jensen
authors: From the Departments of Neurology (L.B., J.H.J., J.B., T.N.), Radiology and Radiological Science (J.H.J.), and Public Health Sciences (N.B.), Medical University of South Carolina, Charleston; the Department of Neurology (J.J.L.), University of California Irvine; the Departments of Neurology and Pediatrics (D.L.D.) and Radiology (A.M.S.), Emory University, Atlanta, GA; the Department of Neurology (J.R.B.), Medical College of Wisconsin, Milwaukee; and the Comprehensive Epilepsy Center (R.I.K.), New York University, New York.
authors: Nathaniel
authors: N
authors: Baker
authors: From the Departments of Neurology (L.B., J.H.J., J.B., T.N.), Radiology and Radiological Science (J.H.J.), and Public Health Sciences (N.B.), Medical University of South Carolina, Charleston; the Department of Neurology (J.J.L.), University of California Irvine; the Departments of Neurology and Pediatrics (D.L.D.) and Radiology (A.M.S.), Emory University, Atlanta, GA; the Department of Neurology (J.R.B.), Medical College of Wisconsin, Milwaukee; and the Comprehensive Epilepsy Center (R.I.K.), New York University, New York.
authors: Jesse
authors: J
authors: Breedlove
authors: From the Departments of Neurology (L.B., J.H.J., J.B., T.N.), Radiology and Radiological Science (J.H.J.), and Public Health Sciences (N.B.), Medical University of South Carolina, Charleston; the Department of Neurology (J.J.L.), University of California Irvine; the Departments of Neurology and Pediatrics (D.L.D.) and Radiology (A.M.S.), Emory University, Atlanta, GA; the Department of Neurology (J.R.B.), Medical College of Wisconsin, Milwaukee; and the Comprehensive Epilepsy Center (R.I.K.), New York University, New York.
authors: Travis
authors: T
authors: Nesland
authors: From the Departments of Neurology (L.B., J.H.J., J.B., T.N.), Radiology and Radiological Science (J.H.J.), and Public Health Sciences (N.B.), Medical University of South Carolina, Charleston; the Department of Neurology (J.J.L.), University of California Irvine; the Departments of Neurology and Pediatrics (D.L.D.) and Radiology (A.M.S.), Emory University, Atlanta, GA; the Department of Neurology (J.R.B.), Medical College of Wisconsin, Milwaukee; and the Comprehensive Epilepsy Center (R.I.K.), New York University, New York.
authors: Jack J
authors: JJ
authors: Lin
authors: From the Departments of Neurology (L.B., J.H.J., J.B., T.N.), Radiology and Radiological Science (J.H.J.), and Public Health Sciences (N.B.), Medical University of South Carolina, Charleston; the Department of Neurology (J.J.L.), University of California Irvine; the Departments of Neurology and Pediatrics (D.L.D.) and Radiology (A.M.S.), Emory University, Atlanta, GA; the Department of Neurology (J.R.B.), Medical College of Wisconsin, Milwaukee; and the Comprehensive Epilepsy Center (R.I.K.), New York University, New York.
authors: Daniel L
authors: DL
authors: Drane
authors: From the Departments of Neurology (L.B., J.H.J., J.B., T.N.), Radiology and Radiological Science (J.H.J.), and Public Health Sciences (N.B.), Medical University of South Carolina, Charleston; the Department of Neurology (J.J.L.), University of California Irvine; the Departments of Neurology and Pediatrics (D.L.D.) and Radiology (A.M.S.), Emory University, Atlanta, GA; the Department of Neurology (J.R.B.), Medical College of Wisconsin, Milwaukee; and the Comprehensive Epilepsy Center (R.I.K.), New York University, New York.
authors: Amit M
authors: AM
authors: Saindane
authors: From the Departments of Neurology (L.B., J.H.J., J.B., T.N.), Radiology and Radiological Science (J.H.J.), and Public Health Sciences (N.B.), Medical University of South Carolina, Charleston; the Department of Neurology (J.J.L.), University of California Irvine; the Departments of Neurology and Pediatrics (D.L.D.) and Radiology (A.M.S.), Emory University, Atlanta, GA; the Department of Neurology (J.R.B.), Medical College of Wisconsin, Milwaukee; and the Comprehensive Epilepsy Center (R.I.K.), New York University, New York.
authors: Jeffrey R
authors: JR
authors: Binder
authors: From the Departments of Neurology (L.B., J.H.J., J.B., T.N.), Radiology and Radiological Science (J.H.J.), and Public Health Sciences (N.B.), Medical University of South Carolina, Charleston; the Department of Neurology (J.J.L.), University of California Irvine; the Departments of Neurology and Pediatrics (D.L.D.) and Radiology (A.M.S.), Emory University, Atlanta, GA; the Department of Neurology (J.R.B.), Medical College of Wisconsin, Milwaukee; and the Comprehensive Epilepsy Center (R.I.K.), New York University, New York.
authors: Ruben I
authors: RI
authors: Kuzniecky
mesh_terms: D000328:Adult; D038481:Anterior Temporal Lobectomy; D001921:Brain / Q000502:physiology / Q000503:physiopathology*; D015331:Cohort Studies; D063132:Connectome; D038524:Diffusion Magnetic Resonance Imaging; D004833:Epilepsy, Temporal Lobe / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009434:Neural Pathways / Q000502:physiology / Q000503:physiopathology*; D012189:Retrospective Studies; D016896:Treatment Outcome