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Lateralizing Value of Artificial Intelligence-Based Segmentation Software in MRI-Negative Focal Epilepsy.

Kyung-Il Park1,2, Hyoshin Son3, Sungeun Hwang4

  • 1Department of Neurology, Seoul National University College of Medicine, Seoul, Korea.

Journal of Epilepsy Research
|December 25, 2024
PubMed
Summary

Artificial intelligence tools can help lateralize non-lesional frontal lobe epilepsy (FLE) by measuring cortical thickness. This AI approach is particularly useful for identifying epilepsy laterality in patients with longer disease duration.

Keywords:
Artificial intelligenceAsymmetryFrontal lobe epilepsyMRI-negative epilepsy

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Area of Science:

  • Neuroimaging
  • Artificial Intelligence
  • Epilepsy Research

Background:

  • Accurate lesion detection in epilepsy via magnetic resonance imaging (MRI) is critical for diagnosis and surgical planning.
  • Automated artificial intelligence (AI) tools, initially developed for dementia, can measure cortical thickness and brain volume.

Purpose of the Study:

  • To determine if AI-based measurements of cortical thickness and brain volume can lateralize epilepsy in patients with normal-appearing MRIs.
  • To investigate the utility of AI in identifying epilepsy laterality in non-lesional cases.

Main Methods:

  • Analysis of 3-Tesla MRIs from 428 patients with focal epilepsy (non-lesional).
  • Utilized AI segmentation/volumetry software to measure cortical thickness and hippocampal volume.
  • Calculated the laterality index (LI) to assess differences between hemispheres.

Main Results:

  • Frontal lobe epilepsy (FLE) showed significant differences in frontal cortical thickness LI between left and right-sided epilepsy (p=0.01).
  • Patients with identifiable lateralization in FLE had a longer epilepsy duration (12.7 years) compared to non-identifiable cases (8.3 years; p=0.03).
  • The rostral middle frontal cortex was a key region for differentiating FLE laterality; other epilepsy types (TLE, PLE, OLE) did not show significant laterality differences.

Conclusions:

  • AI-based brain segmentation software aids in determining laterality for non-lesional frontal lobe epilepsy.
  • The effectiveness of AI in lateralization is more pronounced in cases with a longer duration of the disease.