{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T22:26:37Z","timestamp":1790115997215,"version":"4.0.1"},"reference-count":50,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,4,22]],"date-time":"2022-04-22T00:00:00Z","timestamp":1650585600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2022,4,22]],"date-time":"2022-04-22T00:00:00Z","timestamp":1650585600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["R01\u2010NS097719"],"award-info":[{"award-number":["R01\u2010NS097719"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["R01\u2010NS92882"],"award-info":[{"award-number":["R01\u2010NS92882"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000083","name":"Directorate for Computer and Information Science and Engineering","doi-asserted-by":"publisher","award":["IIS\u20102105233"],"award-info":[{"award-number":["IIS\u20102105233"]}],"id":[{"id":"10.13039\/100000083","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Anterior temporal lobectomy (ATL) is a widely performed and successful intervention for drug\u2010resistant temporal lobe epilepsy (TLE). However, up to one third of patients experience seizure recurrence within 1\u00a0year after ATL. Despite the extensive literature on presurgical electroencephalography (EEG) and magnetic resonance imaging (MRI) abnormalities to prognosticate seizure freedom following ATL, the value of quantitative analysis of visually reviewed normal interictal EEG in such prognostication remains unclear. In this retrospective multicenter study, we investigate whether machine learning analysis of normal interictal scalp EEG studies can inform the prediction of postoperative seizure freedom outcomes in patients who have undergone ATL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed normal presurgical scalp EEG recordings from 41\u00a0Mayo Clinic (MC) and 23 Cleveland Clinic (CC) patients. We used an unbiased automated algorithm to extract eyes closed awake epochs from scalp EEG studies that were free of any epileptiform activity and then extracted spectral EEG features representing (a) spectral power and (b) interhemispheric spectral coherence in frequencies between 1 and 25\u00a0Hz across several brain regions. We analyzed the differences between the seizure\u2010free and non\u2013seizure\u2010free patients and employed a Na\u00efve Bayes classifier using multiple spectral features to predict surgery outcomes. We trained the classifier using a leave\u2010one\u2010patient\u2010out cross\u2010validation scheme within the MC data set and then tested using the out\u2010of\u2010sample CC data set. Finally, we compared the predictive performance of normal scalp EEG\u2010derived features against MRI abnormalities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We found that several spectral power and coherence features showed significant differences correlated with surgical outcomes and that they were most pronounced in the 10\u201325\u00a0Hz range. The Na\u00efve Bayes classification based on those features predicted 1\u2010year seizure freedom following ATL with area under the curve (AUC) values of 0.78 and 0.76 for the MC and CC data sets, respectively. Subsequent analyses revealed that (a) interhemispheric spectral coherence\u00a0features in the 10\u201325\u00a0Hz range provided better predictability than other combinations and (b) normal scalp EEG\u2010derived features provided superior and potentially distinct predictive value when compared with MRI abnormalities (&gt;10% higher F1 score).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>These results support that quantitative analysis of even a normal presurgical scalp EEG may help prognosticate seizure freedom following ATL in patients with drug\u2010resistant TLE. Although the mechanism for this result is not known, the scalp EEG spectral and coherence properties predicting seizure freedom may represent activity arising from the neocortex or the networks responsible for temporal lobe seizure generation within vs outside the margins of an ATL.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/epi.17257","type":"journal-article","created":{"date-parts":[[2022,4,13]],"date-time":"2022-04-13T08:14:43Z","timestamp":1649837683000},"page":"1630-1642","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Quantitative analysis of visually reviewed normal scalp EEG predicts seizure freedom following anterior temporal lobectomy"],"prefix":"10.1111","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4547-0036","authenticated-orcid":false,"given":"Yogatheesan","family":"Varatharajah","sequence":"first","affiliation":[{"name":"Department of Bioengineering University of Illinois at Urbana Champaign  Urbana Illinois USA"},{"name":"Departments of Neurology and Physiology &amp; Biomedical Engineering Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1576-9344","authenticated-orcid":false,"given":"Boney","family":"Joseph","sequence":"additional","affiliation":[{"name":"Departments of Neurology and Physiology &amp; Biomedical Engineering Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2392-8608","authenticated-orcid":false,"given":"Benjamin","family":"Brinkmann","sequence":"additional","affiliation":[{"name":"Departments of Neurology and Physiology &amp; Biomedical Engineering Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcia","family":"Morita\u2010Sherman","sequence":"additional","affiliation":[{"name":"Epilepsy Center Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6702-1063","authenticated-orcid":false,"given":"Zachary","family":"Fitzgerald","sequence":"additional","affiliation":[{"name":"Epilepsy Center Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Vegh","sequence":"additional","affiliation":[{"name":"Epilepsy Center Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dileep","family":"Nair","sequence":"additional","affiliation":[{"name":"Epilepsy Center Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Burgess","sequence":"additional","affiliation":[{"name":"Epilepsy Center Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9336-9568","authenticated-orcid":false,"given":"Fernando","family":"Cendes","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Campinas UNICAMP  Campinas Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8041-6377","authenticated-orcid":false,"given":"Lara","family":"Jehi","sequence":"additional","affiliation":[{"name":"Epilepsy Center Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"Worrell","sequence":"additional","affiliation":[{"name":"Departments of Neurology and Physiology &amp; 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