Prognostic Values of Thalamic Metabolic Abnormalities in Children with Epilepsy
Bibliographic record
Abstract
Background: Hypometabolism of the thalamus has been reported in epilepsy patients. This study aimed to investigate the prognostic value of thalamic metabolic activity in children with epilepsy. Methods: A total of 200 children with epilepsy and 237 children without epilepsy (sex- and age-matched control group) underwent 18F-FDG PET/CT in this study. Localization of the interictal hypometabolic epileptic focus was performed visually. Bilateral thalamic metabolic activity was evaluated qualitatively (thalamic FDG uptake in relation to the cerebral cortex) and semi-quantitatively (SUV max, normalized SUV (ratio to ipsilateral cerebellum), and absolute asymmetric index (AAI). Results: A total of 133 patients (66.5%) with epilepsy showed cerebral cortical hypometabolism in the interictal 18F-FDG PET study; there were 76 patients on the right side, 55 patients on the left side, and two patients on both sides. Of these 133 patients, 45 also had visually observed asymmetric hypometabolism in the thalamus. Semi-quantitatively, asymmetry was more prominent in epileptic patients. AAI was a more sensitive variable than other variables. Average AAIs were 3.89% and 7.36% in the control and epilepsy patients, respectively. Metabolic activity in the thalami was significantly reduced in epileptic patients compared to the control group. Associated hypometabolism of the ipsilateral thalamus was observed in 66.5% of epileptic patients with a focal cortical defect semi-quantitatively. Overall, 61 out of 200 patients showed thalamus hypometabolism. Some 51 out of 61 patients (83.6%) with thalamus hypometabolism showed refractory disease; however, the refractory disease was noted in 90 out of 139 (64.7%) patients without thalamus hypometabolism. Brain surgery was performed in 86 epileptic patients (43%). Some 35 out of 86 patients had thalamus hypometabolism. Recurrence of epilepsy was observed more in patients with thalamus hypometabolism (48% vs. 25%), with p ≤ 0.01. Conclusion: This study suggests that patients with thalamus metabolic abnormalities may be more medically resistant to therapy and less responsive to surgical treatments. Therefore, the thalamus metabolic abnormality could be used as a prognostic sign in pediatric epilepsy. Recent studies have also suggested that incorporating thalamic metabolic data into clinical workflows may improve the stratification of treatment-resistant epilepsy in children.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".