{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T12:14:21Z","timestamp":1790511261034,"version":"4.1.0"},"reference-count":25,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2024,9,29]],"date-time":"2024-09-29T00:00:00Z","timestamp":1727568000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP21K15720"],"award-info":[{"award-number":["JP21K15720"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["22007"],"award-info":[{"award-number":["22007"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012628","name":"Japan Epilepsy Research Foundation","doi-asserted-by":"publisher","award":["JP21K15720"],"award-info":[{"award-number":["JP21K15720"]}],"id":[{"id":"10.13039\/501100012628","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012628","name":"Japan Epilepsy Research Foundation","doi-asserted-by":"publisher","award":["22007"],"award-info":[{"award-number":["22007"]}],"id":[{"id":"10.13039\/501100012628","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Uehara Memorial Foundation","award":["JP21K15720"],"award-info":[{"award-number":["JP21K15720"]}]},{"name":"Uehara Memorial Foundation","award":["22007"],"award-info":[{"award-number":["22007"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Background\/Objectives: Although the involvement of progressive brain alterations in epilepsy was recently suggested, individual patients\u2019 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 (p &lt; 0.001) and a greater number of ASMs (p = 0.001). Conclusions: the disease progression model based on WM tracts may be useful as a novel individual-level biomarker.<\/jats:p>","DOI":"10.3390\/brainsci14100992","type":"journal-article","created":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T08:09:52Z","timestamp":1727683792000},"page":"992","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Estimated Disease Progression Trajectory of White Matter Disruption in Unilateral Temporal Lobe Epilepsy: A Data-Driven Machine Learning Approach"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9617-706X","authenticated-orcid":false,"given":"Daichi","family":"Sone","sequence":"first","affiliation":[{"name":"Department of Radiology, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan"},{"name":"Department of Psychiatry, Jikei University School of Medicine, Tokyo 105-8461, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriko","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Radiology, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoko","family":"Shigemoto","sequence":"additional","affiliation":[{"name":"Department of Radiology, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4750-3433","authenticated-orcid":false,"given":"Iman","family":"Beheshti","sequence":"additional","affiliation":[{"name":"Department of Human Anatomy and Cell Science, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB R3E 0J9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukio","family":"Kimura","sequence":"additional","affiliation":[{"name":"Department of Radiology, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Matsuda","sequence":"additional","affiliation":[{"name":"Department of Radiology, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1016\/S0140-6736(18)32596-0","article-title":"Epilepsy in adults","volume":"393","author":"Thijs","year":"2019","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1016\/S1474-4422(18)30454-X","article-title":"Global, regional, and national burden of epilepsy, 1990\u20132016: A systematic analysis for the Global Burden of Disease Study 2016","volume":"18","author":"Collaborators","year":"2019","journal-title":"Lancet Neurol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1007\/s11910-019-0947-6","article-title":"Global Health and Epilepsy: Update and Future Directions","volume":"19","author":"Spiciarich","year":"2019","journal-title":"Curr. 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