Identifying important factors for successful surgery in patients with lateral temporal lobe epilepsy
<h4>Objective</h4> Lateral temporal lobe epilepsy (LTLE) has been diagnosed in only a small number of patients; therefore, its surgical outcome is not as well-known as that of mesial temporal lobe epilepsy. We aimed to evaluate the long-term (5 years) and short-term (2 years) surgical ou...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2023-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10310033/?tool=EBI |
| _version_ | 1797788236666372096 |
|---|---|
| author | Jae Rim Kim Hyunjin Jo Boram Park Yu Hyun Park Yeon Hak Chung Young-Min Shon Dae-Won Seo Seung Bong Hong Seung-Chyul Hong Sang Won Seo Eun Yeon Joo |
| author_facet | Jae Rim Kim Hyunjin Jo Boram Park Yu Hyun Park Yeon Hak Chung Young-Min Shon Dae-Won Seo Seung Bong Hong Seung-Chyul Hong Sang Won Seo Eun Yeon Joo |
| author_sort | Jae Rim Kim |
| collection | DOAJ |
| description | <h4>Objective</h4> Lateral temporal lobe epilepsy (LTLE) has been diagnosed in only a small number of patients; therefore, its surgical outcome is not as well-known as that of mesial temporal lobe epilepsy. We aimed to evaluate the long-term (5 years) and short-term (2 years) surgical outcomes and identify possible prognostic factors in patients with LTLE. <h4>Methods</h4> This retrospective cohort study was conducted between January 1995 and December 2018 among patients who underwent resective surgery in a university-affiliated hospital. Patients were classified as LTLE if ictal onset zone was in lateral temporal area. Surgical outcomes were evaluated at 2 and 5 years. We subdivided based on outcomes and compared clinical and neuroimaging data including cortical thickness between two groups. <h4>Results</h4> Sixty-four patients were included in the study. The mean follow-up duration after the surgery was 8.4 years. Five years after surgery, 45 of the 63 (71.4%) patients achieved seizure freedom. Clinically and statistically significant prognostic factors for postsurgical outcomes were the duration of epilepsy before surgery and focal cortical dysplasia on postoperative histopathology at the 5-year follow-up. Optimal cut-off point for epilepsy duration was eight years after the seizure onset (odds ratio 4.375, p-value = 0.0214). Furthermore, we propose a model for predicting seizure outcomes 5 years after surgery using the receiver operating characteristic curve and nomogram (area under the curve = 0.733; 95% confidence interval, 0.588–0.879). Cortical thinning was observed in ipsilateral cingulate gyrus and contralateral parietal lobe in poor surgical group compared to good surgical group (p-value < 0.01, uncorrected). <h4>Conclusions</h4> The identified predictors of unfavorable surgical outcomes may help in selecting optimal candidates and identifying the optimal timing for surgery among patients with LTLE. Additionally, cortical thinning was more extensive in the poor surgical group. |
| first_indexed | 2024-03-13T01:32:46Z |
| format | Article |
| id | doaj.art-269e70616c83460a83a85ed5f3ba24e6 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-03-13T01:32:46Z |
| publishDate | 2023-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-269e70616c83460a83a85ed5f3ba24e62023-07-04T05:32:54ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-01186Identifying important factors for successful surgery in patients with lateral temporal lobe epilepsyJae Rim KimHyunjin JoBoram ParkYu Hyun ParkYeon Hak ChungYoung-Min ShonDae-Won SeoSeung Bong HongSeung-Chyul HongSang Won SeoEun Yeon Joo<h4>Objective</h4> Lateral temporal lobe epilepsy (LTLE) has been diagnosed in only a small number of patients; therefore, its surgical outcome is not as well-known as that of mesial temporal lobe epilepsy. We aimed to evaluate the long-term (5 years) and short-term (2 years) surgical outcomes and identify possible prognostic factors in patients with LTLE. <h4>Methods</h4> This retrospective cohort study was conducted between January 1995 and December 2018 among patients who underwent resective surgery in a university-affiliated hospital. Patients were classified as LTLE if ictal onset zone was in lateral temporal area. Surgical outcomes were evaluated at 2 and 5 years. We subdivided based on outcomes and compared clinical and neuroimaging data including cortical thickness between two groups. <h4>Results</h4> Sixty-four patients were included in the study. The mean follow-up duration after the surgery was 8.4 years. Five years after surgery, 45 of the 63 (71.4%) patients achieved seizure freedom. Clinically and statistically significant prognostic factors for postsurgical outcomes were the duration of epilepsy before surgery and focal cortical dysplasia on postoperative histopathology at the 5-year follow-up. Optimal cut-off point for epilepsy duration was eight years after the seizure onset (odds ratio 4.375, p-value = 0.0214). Furthermore, we propose a model for predicting seizure outcomes 5 years after surgery using the receiver operating characteristic curve and nomogram (area under the curve = 0.733; 95% confidence interval, 0.588–0.879). Cortical thinning was observed in ipsilateral cingulate gyrus and contralateral parietal lobe in poor surgical group compared to good surgical group (p-value < 0.01, uncorrected). <h4>Conclusions</h4> The identified predictors of unfavorable surgical outcomes may help in selecting optimal candidates and identifying the optimal timing for surgery among patients with LTLE. Additionally, cortical thinning was more extensive in the poor surgical group.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10310033/?tool=EBI |
| spellingShingle | Jae Rim Kim Hyunjin Jo Boram Park Yu Hyun Park Yeon Hak Chung Young-Min Shon Dae-Won Seo Seung Bong Hong Seung-Chyul Hong Sang Won Seo Eun Yeon Joo Identifying important factors for successful surgery in patients with lateral temporal lobe epilepsy PLoS ONE |
| title | Identifying important factors for successful surgery in patients with lateral temporal lobe epilepsy |
| title_full | Identifying important factors for successful surgery in patients with lateral temporal lobe epilepsy |
| title_fullStr | Identifying important factors for successful surgery in patients with lateral temporal lobe epilepsy |
| title_full_unstemmed | Identifying important factors for successful surgery in patients with lateral temporal lobe epilepsy |
| title_short | Identifying important factors for successful surgery in patients with lateral temporal lobe epilepsy |
| title_sort | identifying important factors for successful surgery in patients with lateral temporal lobe epilepsy |
| url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10310033/?tool=EBI |
| work_keys_str_mv | AT jaerimkim identifyingimportantfactorsforsuccessfulsurgeryinpatientswithlateraltemporallobeepilepsy AT hyunjinjo identifyingimportantfactorsforsuccessfulsurgeryinpatientswithlateraltemporallobeepilepsy AT borampark identifyingimportantfactorsforsuccessfulsurgeryinpatientswithlateraltemporallobeepilepsy AT yuhyunpark identifyingimportantfactorsforsuccessfulsurgeryinpatientswithlateraltemporallobeepilepsy AT yeonhakchung identifyingimportantfactorsforsuccessfulsurgeryinpatientswithlateraltemporallobeepilepsy AT youngminshon identifyingimportantfactorsforsuccessfulsurgeryinpatientswithlateraltemporallobeepilepsy AT daewonseo identifyingimportantfactorsforsuccessfulsurgeryinpatientswithlateraltemporallobeepilepsy AT seungbonghong identifyingimportantfactorsforsuccessfulsurgeryinpatientswithlateraltemporallobeepilepsy AT seungchyulhong identifyingimportantfactorsforsuccessfulsurgeryinpatientswithlateraltemporallobeepilepsy AT sangwonseo identifyingimportantfactorsforsuccessfulsurgeryinpatientswithlateraltemporallobeepilepsy AT eunyeonjoo identifyingimportantfactorsforsuccessfulsurgeryinpatientswithlateraltemporallobeepilepsy |