Hemispherectomy Outcome Prediction Scale: Development and validation of a seizure freedom prediction tool

Alexander G. Weil; Evan C. Lewis; George M. Ibrahim; Olivia Kola; Chi Hong Tseng; Xinkai Zhou; Kao Min Lin; Li Xin Cai; Qing Zhu Liu; Jiu Luan Lin; Wen Jing Zhou; Gary W. Mathern; Matthew D. Smyth; Brent R. O'Neill; Roy Dudley; John Ragheb; Sanjiv Bhatia; Daniel Delev; Georgia Ramantani; Josef Zentner; Jeffrey Ojemann; Anthony C. Wang; Christian Dorfer; Martha Feucht; Thomas Czech; Robert J. Bollo; Galymzhan Issabekov; Hongwei Zhu; Mary Connelly; Paul Steinbok; Jian Guo Zhang; Kai Zhang; Eveline Teresa Hidalgo; Howard L. Weiner; Lily Wong-Kisiel; Samuel Lapalme-Remis; Manjari Tripathi; Poodipedi Sarat Chandra; Walter Hader; Feng Peng Wang; Yi Yao; Pierre Olivier Champagne; Qiang Guo; Shao Chun Li; Marcelo Budke; Maria Angeles Pérez-Jiménez; Christian Raftapoulos; Patrice Finet; Pauline Michel; Karl Schaller; Martin N. Stienen; Valentina Baro; Christian Cantillano Malone; Juan Pociecha; Noelia Chamorro; Valeria L. Muro; Marec von Lehe; Silvia Vieker; Chima Oluigbo; William D. Gaillard; Mashael Al Khateeb; Faisal Al Otaibi; Niklaus Krayenbühl; Jeffrey Bolton; Phillip L. Pearl; Aria Fallah

doi:10.1111/epi.16861

Hemispherectomy Outcome Prediction Scale: Development and validation of a seizure freedom prediction tool

Alexander G. Weil, Evan C. Lewis, George M. Ibrahim, Olivia Kola, Chi Hong Tseng, Xinkai Zhou, Kao Min Lin, Li Xin Cai, Qing Zhu Liu, Jiu Luan Lin, Wen Jing Zhou, Gary W. Mathern, Matthew D. Smyth, Brent R. O'Neill, Roy Dudley, John Ragheb, Sanjiv Bhatia, Daniel Delev, Georgia Ramantani, Josef ZentnerJeffrey Ojemann, Anthony C. Wang, Christian Dorfer, Martha Feucht, Thomas Czech, Robert J. Bollo, Galymzhan Issabekov, Hongwei Zhu, Mary Connelly, Paul Steinbok, Jian Guo Zhang, Kai Zhang, Eveline Teresa Hidalgo, Howard L. Weiner, Lily Wong-Kisiel, Samuel Lapalme-Remis, Manjari Tripathi, Poodipedi Sarat Chandra, Walter Hader, Feng Peng Wang, Yi Yao, Pierre Olivier Champagne, Qiang Guo, Shao Chun Li, Marcelo Budke, Maria Angeles Pérez-Jiménez, Christian Raftapoulos, Patrice Finet, Pauline Michel, Karl Schaller, Martin N. Stienen, Valentina Baro, Christian Cantillano Malone, Juan Pociecha, Noelia Chamorro, Valeria L. Muro, Marec von Lehe, Silvia Vieker, Chima Oluigbo, William D. Gaillard, Mashael Al Khateeb, Faisal Al Otaibi, Niklaus Krayenbühl, Jeffrey Bolton, Phillip L. Pearl, Aria Fallah

Neurology

Research output: Contribution to journal › Article › peer-review

1 Scopus citations

Abstract

Objective: To develop and validate a model to predict seizure freedom in children undergoing cerebral hemispheric surgery for the treatment of drug-resistant epilepsy. Methods: We analyzed 1267 hemispheric surgeries performed in pediatric participants across 32 centers and 12 countries to identify predictors of seizure freedom at 3 months after surgery. A multivariate logistic regression model was developed based on 70% of the dataset (training set) and validated on 30% of the dataset (validation set). Missing data were handled using multiple imputation techniques. Results: Overall, 817 of 1237 (66%) hemispheric surgeries led to seizure freedom (median follow-up = 24 months), and 1050 of 1237 (85%) were seizure-free at 12 months after surgery. A simple regression model containing age at seizure onset, presence of generalized seizure semiology, presence of contralateral 18-fluoro-2-deoxyglucose–positron emission tomography hypometabolism, etiologic substrate, and previous nonhemispheric resective surgery is predictive of seizure freedom (area under the curve =.72). A Hemispheric Surgery Outcome Prediction Scale (HOPS) score was devised that can be used to predict seizure freedom. Significance: Children most likely to benefit from hemispheric surgery can be selected and counseled through the implementation of a scale derived from a multiple regression model. Importantly, children who are unlikely to experience seizure control can be spared from the complications and deficits associated with this surgery. The HOPS score is likely to help physicians in clinical decision-making.

Original language	English (US)
Pages (from-to)	1064-1073
Number of pages	10
Journal	Epilepsia
Volume	62
Issue number	5
DOIs	https://doi.org/10.1111/epi.16861
State	Published - May 2021

Keywords

hemispheric surgery
prognostication tool
seizure outcomes

ASJC Scopus subject areas

Neurology
Clinical Neurology

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10.1111/epi.16861

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Weil, A. G., Lewis, E. C., Ibrahim, G. M., Kola, O., Tseng, C. H., Zhou, X., Lin, K. M., Cai, L. X., Liu, Q. Z., Lin, J. L., Zhou, W. J., Mathern, G. W., Smyth, M. D., O'Neill, B. R., Dudley, R., Ragheb, J., Bhatia, S., Delev, D., Ramantani, G., ... Fallah, A. (2021). Hemispherectomy Outcome Prediction Scale: Development and validation of a seizure freedom prediction tool. Epilepsia, 62(5), 1064-1073. https://doi.org/10.1111/epi.16861

Weil, AG, Lewis, EC, Ibrahim, GM, Kola, O, Tseng, CH, Zhou, X, Lin, KM, Cai, LX, Liu, QZ, Lin, JL, Zhou, WJ, Mathern, GW, Smyth, MD, O'Neill, BR, Dudley, R, Ragheb, J, Bhatia, S, Delev, D, Ramantani, G, Zentner, J, Ojemann, J, Wang, AC, Dorfer, C, Feucht, M, Czech, T, Bollo, RJ, Issabekov, G, Zhu, H, Connelly, M, Steinbok, P, Zhang, JG, Zhang, K, Hidalgo, ET, Weiner, HL, Wong-Kisiel, L, Lapalme-Remis, S, Tripathi, M, Sarat Chandra, P, Hader, W, Wang, FP, Yao, Y, Olivier Champagne, P, Guo, Q, Li, SC, Budke, M, Pérez-Jiménez, MA, Raftapoulos, C, Finet, P, Michel, P, Schaller, K, Stienen, MN, Baro, V, Cantillano Malone, C, Pociecha, J, Chamorro, N, Muro, VL, von Lehe, M, Vieker, S, Oluigbo, C, Gaillard, WD, Al Khateeb, M, Al Otaibi, F, Krayenbühl, N, Bolton, J, Pearl, PL & Fallah, A 2021, 'Hemispherectomy Outcome Prediction Scale: Development and validation of a seizure freedom prediction tool', Epilepsia, vol. 62, no. 5, pp. 1064-1073. https://doi.org/10.1111/epi.16861

@article{e0c1f1341da8445a8e917d080dffbf69,

title = "Hemispherectomy Outcome Prediction Scale: Development and validation of a seizure freedom prediction tool",

abstract = "Objective: To develop and validate a model to predict seizure freedom in children undergoing cerebral hemispheric surgery for the treatment of drug-resistant epilepsy. Methods: We analyzed 1267 hemispheric surgeries performed in pediatric participants across 32 centers and 12 countries to identify predictors of seizure freedom at 3 months after surgery. A multivariate logistic regression model was developed based on 70% of the dataset (training set) and validated on 30% of the dataset (validation set). Missing data were handled using multiple imputation techniques. Results: Overall, 817 of 1237 (66%) hemispheric surgeries led to seizure freedom (median follow-up = 24 months), and 1050 of 1237 (85%) were seizure-free at 12 months after surgery. A simple regression model containing age at seizure onset, presence of generalized seizure semiology, presence of contralateral 18-fluoro-2-deoxyglucose–positron emission tomography hypometabolism, etiologic substrate, and previous nonhemispheric resective surgery is predictive of seizure freedom (area under the curve =.72). A Hemispheric Surgery Outcome Prediction Scale (HOPS) score was devised that can be used to predict seizure freedom. Significance: Children most likely to benefit from hemispheric surgery can be selected and counseled through the implementation of a scale derived from a multiple regression model. Importantly, children who are unlikely to experience seizure control can be spared from the complications and deficits associated with this surgery. The HOPS score is likely to help physicians in clinical decision-making.",

keywords = "hemispheric surgery, prognostication tool, seizure outcomes",

author = "Weil, {Alexander G.} and Lewis, {Evan C.} and Ibrahim, {George M.} and Olivia Kola and Tseng, {Chi Hong} and Xinkai Zhou and Lin, {Kao Min} and Cai, {Li Xin} and Liu, {Qing Zhu} and Lin, {Jiu Luan} and Zhou, {Wen Jing} and Mathern, {Gary W.} and Smyth, {Matthew D.} and O'Neill, {Brent R.} and Roy Dudley and John Ragheb and Sanjiv Bhatia and Daniel Delev and Georgia Ramantani and Josef Zentner and Jeffrey Ojemann and Wang, {Anthony C.} and Christian Dorfer and Martha Feucht and Thomas Czech and Bollo, {Robert J.} and Galymzhan Issabekov and Hongwei Zhu and Mary Connelly and Paul Steinbok and Zhang, {Jian Guo} and Kai Zhang and Hidalgo, {Eveline Teresa} and Weiner, {Howard L.} and Lily Wong-Kisiel and Samuel Lapalme-Remis and Manjari Tripathi and {Sarat Chandra}, Poodipedi and Walter Hader and Wang, {Feng Peng} and Yi Yao and {Olivier Champagne}, Pierre and Qiang Guo and Li, {Shao Chun} and Marcelo Budke and P{\'e}rez-Jim{\'e}nez, {Maria Angeles} and Christian Raftapoulos and Patrice Finet and Pauline Michel and Karl Schaller and Stienen, {Martin N.} and Valentina Baro and {Cantillano Malone}, Christian and Juan Pociecha and Noelia Chamorro and Muro, {Valeria L.} and {von Lehe}, Marec and Silvia Vieker and Chima Oluigbo and Gaillard, {William D.} and {Al Khateeb}, Mashael and {Al Otaibi}, Faisal and Niklaus Krayenb{\"u}hl and Jeffrey Bolton and Pearl, {Phillip L.} and Aria Fallah",

note = "Publisher Copyright: {\textcopyright} 2021 International League Against Epilepsy",

year = "2021",

month = may,

doi = "10.1111/epi.16861",

language = "English (US)",

volume = "62",

pages = "1064--1073",

journal = "Epilepsia",

issn = "0013-9580",

publisher = "Wiley-Blackwell",

number = "5",

}

TY - JOUR

T1 - Hemispherectomy Outcome Prediction Scale

T2 - Development and validation of a seizure freedom prediction tool

AU - Weil, Alexander G.

AU - Lewis, Evan C.

AU - Ibrahim, George M.

AU - Kola, Olivia

AU - Tseng, Chi Hong

AU - Zhou, Xinkai

AU - Lin, Kao Min

AU - Cai, Li Xin

AU - Liu, Qing Zhu

AU - Lin, Jiu Luan

AU - Zhou, Wen Jing

AU - Mathern, Gary W.

AU - Smyth, Matthew D.

AU - O'Neill, Brent R.

AU - Dudley, Roy

AU - Ragheb, John

AU - Bhatia, Sanjiv

AU - Delev, Daniel

AU - Ramantani, Georgia

AU - Zentner, Josef

AU - Ojemann, Jeffrey

AU - Wang, Anthony C.

AU - Dorfer, Christian

AU - Feucht, Martha

AU - Czech, Thomas

AU - Bollo, Robert J.

AU - Issabekov, Galymzhan

AU - Zhu, Hongwei

AU - Connelly, Mary

AU - Steinbok, Paul

AU - Zhang, Jian Guo

AU - Zhang, Kai

AU - Hidalgo, Eveline Teresa

AU - Weiner, Howard L.

AU - Wong-Kisiel, Lily

AU - Lapalme-Remis, Samuel

AU - Tripathi, Manjari

AU - Sarat Chandra, Poodipedi

AU - Hader, Walter

AU - Wang, Feng Peng

AU - Yao, Yi

AU - Olivier Champagne, Pierre

AU - Guo, Qiang

AU - Li, Shao Chun

AU - Budke, Marcelo

AU - Pérez-Jiménez, Maria Angeles

AU - Raftapoulos, Christian

AU - Finet, Patrice

AU - Michel, Pauline

AU - Schaller, Karl

AU - Stienen, Martin N.

AU - Baro, Valentina

AU - Cantillano Malone, Christian

AU - Pociecha, Juan

AU - Chamorro, Noelia

AU - Muro, Valeria L.

AU - von Lehe, Marec

AU - Vieker, Silvia

AU - Oluigbo, Chima

AU - Gaillard, William D.

AU - Al Khateeb, Mashael

AU - Al Otaibi, Faisal

AU - Krayenbühl, Niklaus

AU - Bolton, Jeffrey

AU - Pearl, Phillip L.

AU - Fallah, Aria

PY - 2021/5

Y1 - 2021/5

N2 - Objective: To develop and validate a model to predict seizure freedom in children undergoing cerebral hemispheric surgery for the treatment of drug-resistant epilepsy. Methods: We analyzed 1267 hemispheric surgeries performed in pediatric participants across 32 centers and 12 countries to identify predictors of seizure freedom at 3 months after surgery. A multivariate logistic regression model was developed based on 70% of the dataset (training set) and validated on 30% of the dataset (validation set). Missing data were handled using multiple imputation techniques. Results: Overall, 817 of 1237 (66%) hemispheric surgeries led to seizure freedom (median follow-up = 24 months), and 1050 of 1237 (85%) were seizure-free at 12 months after surgery. A simple regression model containing age at seizure onset, presence of generalized seizure semiology, presence of contralateral 18-fluoro-2-deoxyglucose–positron emission tomography hypometabolism, etiologic substrate, and previous nonhemispheric resective surgery is predictive of seizure freedom (area under the curve =.72). A Hemispheric Surgery Outcome Prediction Scale (HOPS) score was devised that can be used to predict seizure freedom. Significance: Children most likely to benefit from hemispheric surgery can be selected and counseled through the implementation of a scale derived from a multiple regression model. Importantly, children who are unlikely to experience seizure control can be spared from the complications and deficits associated with this surgery. The HOPS score is likely to help physicians in clinical decision-making.

AB - Objective: To develop and validate a model to predict seizure freedom in children undergoing cerebral hemispheric surgery for the treatment of drug-resistant epilepsy. Methods: We analyzed 1267 hemispheric surgeries performed in pediatric participants across 32 centers and 12 countries to identify predictors of seizure freedom at 3 months after surgery. A multivariate logistic regression model was developed based on 70% of the dataset (training set) and validated on 30% of the dataset (validation set). Missing data were handled using multiple imputation techniques. Results: Overall, 817 of 1237 (66%) hemispheric surgeries led to seizure freedom (median follow-up = 24 months), and 1050 of 1237 (85%) were seizure-free at 12 months after surgery. A simple regression model containing age at seizure onset, presence of generalized seizure semiology, presence of contralateral 18-fluoro-2-deoxyglucose–positron emission tomography hypometabolism, etiologic substrate, and previous nonhemispheric resective surgery is predictive of seizure freedom (area under the curve =.72). A Hemispheric Surgery Outcome Prediction Scale (HOPS) score was devised that can be used to predict seizure freedom. Significance: Children most likely to benefit from hemispheric surgery can be selected and counseled through the implementation of a scale derived from a multiple regression model. Importantly, children who are unlikely to experience seizure control can be spared from the complications and deficits associated with this surgery. The HOPS score is likely to help physicians in clinical decision-making.

KW - hemispheric surgery

KW - prognostication tool

KW - seizure outcomes

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U2 - 10.1111/epi.16861

DO - 10.1111/epi.16861

M3 - Article

C2 - 33713438

AN - SCOPUS:85102432647

SN - 0013-9580

VL - 62

SP - 1064

EP - 1073

JO - Epilepsia

JF - Epilepsia

IS - 5

ER -

Hemispherectomy Outcome Prediction Scale: Development and validation of a seizure freedom prediction tool

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