Synchronizability predicts effective responsive neurostimulation for epilepsy prior to treatment
Synchronizability predicts effective responsive neurostimulation for epilepsy prior to treatment
Abstract Despite the success of responsive neurostimulation (RNS) for epilepsy, clinical outcomes vary significantly and are hard to predict. The ability to forecast clinical response to RNS therapy before device implantation would improve patient selection for RNS surgery and could prevent a costly and ineffective intervention. Determining and validating biomarkers predictive of RNS response is difficult, however, due to the heterogeneity of the RNS patient population and clinical procedures; large, multi-center datasets are needed to quantify patient variability and to account for stereotypy in the treatment paradigm of any one center. Here we use a distributed, cloud-based pipeline to analyze a federated dataset of intracranial EEG recordings, collected prior to RNS surgery, from a retrospective cohort of 30 patients across three major epilepsy centers. Based on recent work modelling the controllability of distributed brain networks, we hypothesize that broader brain network connectivity, beyond the seizure onset zone, can predict RNS response. We demonstrate how intracranial EEG recordings can be leveraged through network analysis to uncover biomarkers that predict response to RNS therapy. Our findings suggest that peri-ictal changes in synchronizability, a global network metric shown to accurately predict outcome from resective epilepsy surgery, can distinguish between good and poor RNS responders under the current RNS therapy guidelines (area under the receiver operating characteristic curve of 0.75). Furthermore, this study also provides a proof-of-concept roadmap for multicenter collaboration where practical considerations impede sharing datasets fully across centers.
Friedman Daniel、Litt Brian、Rao Vikram R.、Jeschke Jay、Davis Kathryn A.、Lucas Tim、Doyle Werner、Bernabei John M.、Becker Danielle、Scheid Brittany H.、Chang Edward F.、Bassett Danielle S.、Khambhati Ankit N.
Comprehensive Epilepsy Center, NYU Langone||Department of Neurology, NYU LangoneDepartment of Bioengineering, University of Pennsylvania||Center for Neuroengineering & Therapeutics, University of Pennsylvania||Department of Neurology, Hospital of the University of PennsylvaniDepartment of Neurology, University of CaliforniaComprehensive Epilepsy Center, NYU LangoneDepartment of Bioengineering, University of Pennsylvania||Center for Neuroengineering & Therapeutics, University of Pennsylvania||Department of Neurology, Hospital of the University of PennsylvaniCenter for Neuroengineering & Therapeutics, University of Pennsylvania||Department of Neurosurgery, Perelman School of Medicine, University of PennsylvaniaDepartment of Neurosurgery, NYU LangoneDepartment of Bioengineering, University of Pennsylvania||Center for Neuroengineering & Therapeutics, University of PennsylvaniaCenter for Neuroengineering & Therapeutics, University of Pennsylvania||Department of Neurology, Hospital of the University of PennsylvaniDepartment of Bioengineering, University of Pennsylvania||Center for Neuroengineering & Therapeutics, University of PennsylvaniaDepartment of Neurological Surgery, University of California||Weill Institute for Neurosciences, University of CaliforniaDepartment of Bioengineering, University of Pennsylvania||Department of Neurology, Hospital of the University of Pennsylvani||Department of Physics & Astronomy, College of Arts & Sciences, University of Pennsylvania||Department of Electrical & Systems Engineering, School of Engineering & Applied Science, University of Pennsylvania||Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania||Santa Fe InstituteDepartment of Neurological Surgery, University of California||Weill Institute for Neurosciences, University of California
医学研究方法神经病学、精神病学基础医学
responsive neurostimulationbiomarkersnetwork neuroscienceintracranial EEGsynchronizability
Friedman Daniel,Litt Brian,Rao Vikram R.,Jeschke Jay,Davis Kathryn A.,Lucas Tim,Doyle Werner,Bernabei John M.,Becker Danielle,Scheid Brittany H.,Chang Edward F.,Bassett Danielle S.,Khambhati Ankit N..Synchronizability predicts effective responsive neurostimulation for epilepsy prior to treatment[EB/OL].(2025-03-28)[2025-08-02].https://www.medrxiv.org/content/10.1101/2021.02.05.21250075.点此复制
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