Identification of different MRI atrophy progression trajectories in epilepsy by subtype and stage inference.

Xiao, Fenglai; Caciagli, Lorenzo; Wandschneider, Britta; Sone, Daichi; Young, Alexandra L; Vos, Sjoerd B; Winston, Gavin P; Zhang, Yingying; Liu, Wenyu; An, Dongmei; Kanber, Baris; Zhou, Dong; Sander, Josemir W; Thom, Maria; Duncan, John S; Alexander, Daniel C; Galovic, Marian; Koepp, Matthias J (2023). Identification of different MRI atrophy progression trajectories in epilepsy by subtype and stage inference. Brain : a journal of neurology, 146(11), pp. 4702-4716. Oxford University Press 10.1093/brain/awad284

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Artificial intelligence (AI)-based tools are widely employed, but their use for diagnosis and prognosis of neurological disorders is still evolving. Here we analyse a cross-sectional multicentre structural MRI dataset of 696 people with epilepsy and 118 control subjects. We use an innovative machine-learning algorithm, Subtype and Stage Inference, to develop a novel data-driven disease taxonomy, whereby epilepsy subtypes correspond to distinct patterns of spatiotemporal progression of brain atrophy.In a discovery cohort of 814 individuals, we identify two subtypes common to focal and idiopathic generalized epilepsies, characterized by progression of grey matter atrophy driven by the cortex or the basal ganglia. A third subtype, only detected in focal epilepsies, was characterized by hippocampal atrophy. We corroborate external validity via an independent cohort of 254 people and confirm that the basal ganglia subtype is associated with the most severe epilepsy.Our findings suggest fundamental processes underlying the progression of epilepsy-related brain atrophy. We deliver a novel MRI- and AI-guided epilepsy taxonomy, which could be used for individualized prognostics and targeted therapeutics.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
UniBE Contributor:	Caciagli, Lorenzo
Subjects:	600 Technology > 610 Medicine & health
ISSN:	1460-2156
Publisher:	Oxford University Press
Language:	English
Submitter:	Pubmed Import
Date Deposited:	09 Oct 2023 10:44
Last Modified:	08 Nov 2023 00:16
Publisher DOI:	10.1093/brain/awad284
PubMed ID:	37807084
Uncontrolled Keywords:	MRI brain atrophy disease progression epilepsy subtype and stage inference
URI:	https://boris.unibe.ch/id/eprint/186984