Biology subjects

Schrader, D. V.

Publications and source records attributed to Schrader, D. V..

3 recordsLinked to original sources

bioRxiv2026

Connectome-wide mega-analysis identifies a reproducible functional network signature of temporal lobe epilepsy

Resting-state functional magnetic resonance imaging (MRI) studies have reported abnormal intrinsic functional connectivity (FC) across distributed circuits in patients with temporal lobe epilepsy (TLE), indicating a system-level impact of the disorder. However, findings remain inconsistent due to limited sample sizes and methodological heterogeneity, leaving the structural determinants and clinical relevance of FC alterations unresolved. To identify a robust and reproducible FC signature, we conducted a data-driven, connectome-wide mega-analysis in a large multicentre cohort of 652 participants (297 TLE, 73 disease controls, and 282 healthy controls) with multimodal 3T MRI and deep clinical phenotyping. We identified convergent FC reconfigurations at both group and individual levels that preferentially involved densely connected hubs, manifesting as hyperconnectivity in frontoparietal association systems and hypoconnectivity in temporal and paralimbic systems. Integrating structural cortical wiring features further revealed that these extensive alterations were constrained by corticocortical proximity, microstructural similarity, and white matter connectivity. Clinically, the FC phenotype tracked symptom burden and disease progression, informed postsurgical seizure outcome, and distinguished TLE from other focal epilepsies. Collectively, these findings systematically delineate a neurobiologically grounded, hub-centric pattern of intrinsic network disruption in TLE, anchored in temporolimbic and adjacent transmodal systems, with potential utility for individualized phenotypic stratification and outcome prognostication.

neuroscience↗

bioRxiv2025

The use of Artificial Intelligence in Magnetic Resonance Imaging of Epilepsy: A Systematic Review and Meta-Analysis

BackgroundThe application of artificial intelligence (AI)/machine learning (ML) to MRI can be a powerful tool to streamline clinical decision-making, yet variability amongst MRI sequences and algorithms have hindered appropriate assessment of reliability and generalizability. MethodsWe conducted a systematic review and meta-analysis of the ability of current AI/ML models operating on MRI data for: 1) epilepsy diagnosis, 2) temporal lobe epilepsy lateralization, 3) lesion localization, and 4) post-surgical outcome prediction. Searches were conducted across PubMed, Medline, and Embase databases from inception until January 1, 2025. We selected studies that employed AI/ML models trained on any MRI modality to classify at least ten patients across the four main objectives for qualitative assessment, and further included in the meta-analysis if they reported an accuracy rate. The primary outcome of the meta-analysis was the overall accuracy of AI/ML models trained on MRI data. The secondary outcome was the concomitant risk of bias evaluation using PROBAST. FindingsWe identified 158 studies for qualitative evaluation and 127 studies for inclusion in the meta-analysis. AI/ML on multimodal MRI could accurately distinguish epilepsy patients from healthy controls (overall accuracy: 88% [85-90]), lateralize temporal lobe epilepsy (90% [87-93]), localize epileptogenic lesions (82% [74-88]), and predict post-surgical seizure-freedom (83% [78-87]). Overall, a high risk of bias remains in the literature; participant bias remained high across all outcomes (64-87%), as well as predictor (88-100%) and analysis (83-100%) bias. Outcome bias was low only for AI/ML studies predicting post-surgical outcomes. InterpretationOur results support promising accuracy of AI/ML models in epilepsy diagnostics and prognostics but remain highly susceptible to bias in participants, predictors, outcome, and analysis domains which limits current translation to routine clinical practice. We encourage closer interdisciplinary collaboration between clinical and scientific groups to improve validation studies based on thorough study design, analysis, and reporting.

neuroscience↗

bioRxiv2025

Personalized Biomarkers of Multiscale Functional Alterations in Temporal Lobe Epilepsy

Temporal lobe epilepsy (TLE) presents with substantial inter-patient variability in clinical and neuroimaging manifestations. This multicenter study examined inter-individual differences in spatial patterns of intrinsic brain function in TLE using normative modeling at multiple spatial scales and evaluated the effectiveness of individual functional deviations for clinical diagnosis and postsurgical outcome prediction. We analyzed multimodal MRI data on 298 healthy controls, 282 TLE patients, and 45 disease controls with extratemporal epilepsy. Cortical function was profiled at local, regional, and global scales using brain signal variability, regional homogeneity, and node strength. We estimated patient-specific W-score maps to index deviations from normative metrics. Compared to healthy controls, patients with TLE showed considerable variations in patterns of functional alterations across the cortex, with the highest overlap in the ipsilateral mesiotemporal regions. Connectome-based simulation revealed the paralimbic and medial default mode regions as key disease epicenters. Functional changes were primarily underpinned by superficial white matter anomalies. Supervised pattern learning achieved classification AUCs of 0.76 for TLE versus disease controls, 0.74 for left versus right TLE, and 0.63 for seizure-free versus non-seizure-free TLE, with greater contralateral temporal functional deviations correlating with unfavorable postsurgical seizure outcome. Our findings reveal the heterogeneous impact of TLE on intrinsic cortical function. These biomarkers hold promise for clinical translation, guiding precision therapeutics and enhancing presurgical decision-making in TLE.

neuroscience↗