Estimated Disease Progression Trajectory of White Matter Disruption in Unilateral Temporal Lobe Epilepsy: A Data-Driven Machine Learning Approach

Background/Objectives: Although the involvement of progressive brain alterations in epilepsy was recently suggested, individual patients’ trajectories of white matter (WM) disruption are not known. Methods: We investigated the disease progression patterns of WM damage and its associations with clini...

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Main Authors: Daichi Sone, Noriko Sato, Yoko Shigemoto, Iman Beheshti, Yukio Kimura, Hiroshi Matsuda
Format: Article
Language:English
Published: MDPI AG 2024-09-01
Series:Brain Sciences
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Online Access:https://www.mdpi.com/2076-3425/14/10/992
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author Daichi Sone
Noriko Sato
Yoko Shigemoto
Iman Beheshti
Yukio Kimura
Hiroshi Matsuda
author_facet Daichi Sone
Noriko Sato
Yoko Shigemoto
Iman Beheshti
Yukio Kimura
Hiroshi Matsuda
author_sort Daichi Sone
collection DOAJ
description Background/Objectives: Although the involvement of progressive brain alterations in epilepsy was recently suggested, individual patients’ trajectories of white matter (WM) disruption are not known. Methods: We investigated the disease progression patterns of WM damage and its associations with clinical metrics. We examined the cross-sectional diffusion tensor imaging (DTI) data of 155 patients with unilateral temporal lobe epilepsy (TLE) and 270 age/gender-matched healthy controls, and we then calculated the average fractional anisotropy (FA) values within 20 WM tracts of the whole brain. We used the Subtype and Stage Inference (SuStaIn) program to detect the progression trajectory of FA changes and investigated its association with clinical parameters including onset age, disease duration, drug-responsiveness, and the number of anti-seizure medications (ASMs). Results: The SuStaIn algorithm identified a single subtype model in which the initial damage occurs in the ipsilateral uncinate fasciculus (UF), followed by damage in the forceps, superior longitudinal fasciculus (SLF), and anterior thalamic radiation (ATR). This pattern was replicated when analyzing TLE with hippocampal sclerosis (n = 50) and TLE with no lesions (n = 105) separately. Further-progressed stages were associated with longer disease duration (<i>p</i> < 0.001) and a greater number of ASMs (<i>p</i> = 0.001). Conclusions: the disease progression model based on WM tracts may be useful as a novel individual-level biomarker.
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spelling doaj-art-bb439d19ca554463a09b2606e36f5d422025-08-20T02:11:05ZengMDPI AGBrain Sciences2076-34252024-09-01141099210.3390/brainsci14100992Estimated Disease Progression Trajectory of White Matter Disruption in Unilateral Temporal Lobe Epilepsy: A Data-Driven Machine Learning ApproachDaichi Sone0Noriko Sato1Yoko Shigemoto2Iman Beheshti3Yukio Kimura4Hiroshi Matsuda5Department of Radiology, National Center of Neurology and Psychiatry, Tokyo 187-8551, JapanDepartment of Radiology, National Center of Neurology and Psychiatry, Tokyo 187-8551, JapanDepartment of Radiology, National Center of Neurology and Psychiatry, Tokyo 187-8551, JapanDepartment of Human Anatomy and Cell Science, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB R3E 0J9, CanadaDepartment of Radiology, National Center of Neurology and Psychiatry, Tokyo 187-8551, JapanDepartment of Radiology, National Center of Neurology and Psychiatry, Tokyo 187-8551, JapanBackground/Objectives: Although the involvement of progressive brain alterations in epilepsy was recently suggested, individual patients’ trajectories of white matter (WM) disruption are not known. Methods: We investigated the disease progression patterns of WM damage and its associations with clinical metrics. We examined the cross-sectional diffusion tensor imaging (DTI) data of 155 patients with unilateral temporal lobe epilepsy (TLE) and 270 age/gender-matched healthy controls, and we then calculated the average fractional anisotropy (FA) values within 20 WM tracts of the whole brain. We used the Subtype and Stage Inference (SuStaIn) program to detect the progression trajectory of FA changes and investigated its association with clinical parameters including onset age, disease duration, drug-responsiveness, and the number of anti-seizure medications (ASMs). Results: The SuStaIn algorithm identified a single subtype model in which the initial damage occurs in the ipsilateral uncinate fasciculus (UF), followed by damage in the forceps, superior longitudinal fasciculus (SLF), and anterior thalamic radiation (ATR). This pattern was replicated when analyzing TLE with hippocampal sclerosis (n = 50) and TLE with no lesions (n = 105) separately. Further-progressed stages were associated with longer disease duration (<i>p</i> < 0.001) and a greater number of ASMs (<i>p</i> = 0.001). Conclusions: the disease progression model based on WM tracts may be useful as a novel individual-level biomarker.https://www.mdpi.com/2076-3425/14/10/992temporal lobe epilepsywhite matterdiffusion tensor imagingmachine learning
spellingShingle Daichi Sone
Noriko Sato
Yoko Shigemoto
Iman Beheshti
Yukio Kimura
Hiroshi Matsuda
Estimated Disease Progression Trajectory of White Matter Disruption in Unilateral Temporal Lobe Epilepsy: A Data-Driven Machine Learning Approach
Brain Sciences
temporal lobe epilepsy
white matter
diffusion tensor imaging
machine learning
title Estimated Disease Progression Trajectory of White Matter Disruption in Unilateral Temporal Lobe Epilepsy: A Data-Driven Machine Learning Approach
title_full Estimated Disease Progression Trajectory of White Matter Disruption in Unilateral Temporal Lobe Epilepsy: A Data-Driven Machine Learning Approach
title_fullStr Estimated Disease Progression Trajectory of White Matter Disruption in Unilateral Temporal Lobe Epilepsy: A Data-Driven Machine Learning Approach
title_full_unstemmed Estimated Disease Progression Trajectory of White Matter Disruption in Unilateral Temporal Lobe Epilepsy: A Data-Driven Machine Learning Approach
title_short Estimated Disease Progression Trajectory of White Matter Disruption in Unilateral Temporal Lobe Epilepsy: A Data-Driven Machine Learning Approach
title_sort estimated disease progression trajectory of white matter disruption in unilateral temporal lobe epilepsy a data driven machine learning approach
topic temporal lobe epilepsy
white matter
diffusion tensor imaging
machine learning
url https://www.mdpi.com/2076-3425/14/10/992
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