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Novel DWI Methods to Minimize Postoperative Deficits in Pediatric Epilepsy Surgery.

Award Number: R01NS089659
ORGANIZATION: NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 02/01/2015
PERIOD OF PERFORMANCE END DATE: 06/30/2026

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Novel DWI Methods to Minimize Postoperative Deficits in Pediatric Epilepsy Surgery. - Project Summary/Abstract For the millions of epilepsy patients with drug-resistant seizures, surgical resection of epileptogenic brain tissue is often the only remaining therapeutic option. Especially in young patients who do not obtain seizure control or suffer from unacceptable side effects from medications, there are further concerns about the effect of seizures on development: even brief but repetitive seizures cause cognitive regression and detrimental psychosocial effects. This motivates a particular urgency to investigate a more structured, quantitative, and non-invasive tool, which is capable of informing families and providers to decide timely surgery by accurately providing the probabilities of both favorable and unfavorable postoperative outcomes using data from preoperative imaging analysis at the whole-brain level. The overall goal of this project is to develop a novel tool of benefit-risk analysis for the presurgical evaluation of pediatric drug-resistant focal epilepsy. Toward this goal, we will validate a state- of-the-art deep learning-based diffusion MRI technique to provide the resection margin (i.e., the distance between epileptogenic area and eloquent area) resulting in maximized benefits (i.e., seizure freedom and long- term neurocognitive improvement) and minimized risk (i.e., deficits in eloquent functions including motor/language/hearing/vision). With NIH support, we have established diffusion-weighted imaging maximum a posteriori probability (DWI-MAP) analysis with Kalman filter, which can provide individual patients with the optimal resection margin, yielding successful avoidance of motor/language/visual deficits in 93%/91%/90% of patients with ≥75% of patients benefiting from seizure freedom. Recently, we have also found that deep convolutional neural network (DCNN) can provide an excellent accuracy (94-100%) to classify true positive tracts of eloquent brain areas, suggesting that DCNN-based tract classification may outperform the DWI-MAP in detecting diverse function-specific white matter pathways. Aim 1 of this project will investigate if a combination of DCNN-based tract classification with Kalman filter even better predicts the resection margin, resulting in seizure freedom and avoidance of functional deficits at a large cohort. Aim 2 will investigate if an advanced DWI approach integrating DCNN and DWI connectome helps decide timely surgery by providing 1) preoperative imaging markers underlying high likelihood of postoperative neurocognitive improvements and 2) mechanistic insight in structural brain reorganization associated with postoperative verbal IQ improvement. The results of this project are expected to ultimately improve clinical management of pediatric epilepsy by translating deep learning- based diffusion MRI technique to optimize the surgical margin, predict the postoperative neurocognitive outcome, and determine specific mechanism of postoperative brain reorganization, which will be validated for optimizing clinical benefit-risk analysis before surgical intervention.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $395,109 )
2025	2025	WAYNE STATE UNIVERSITY	5700 CASS AVE STE 4900	DETROIT	MI	48202	WAYNE	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	000	10	5/30/2025	NON-COMPETING CONTINUATION	$395,109
														Subtotal = $395,109

Issue Date FY: 2024 ( Subtotal = $403,952 )
2024	2024	WAYNE STATE UNIVERSITY	5700 CASS AVE STE 4900	DETROIT	MI	48202	WAYNE	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	000	9	6/7/2024	NON-COMPETING CONTINUATION	$403,952
														Subtotal = $403,952

Issue Date FY: 2023 ( Subtotal = $443,284 )
2023	2023	WAYNE STATE UNIVERSITY	5057 WOODWARD STE 13001	DETROIT	MI	48202	WAYNE	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	000	8	6/9/2023	NON-COMPETING CONTINUATION	$443,284
														Subtotal = $443,284

Issue Date FY: 2022 ( Subtotal = $433,282 )
2022	2022	WAYNE STATE UNIVERSITY	5057 WOODWARD STE 13001	DETROIT	MI	48202	WAYNE	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	002	7	5/27/2022	NON-COMPETING CONTINUATION	$433,282
2022	2021	WAYNE STATE UNIVERSITY	5057 WOODWARD STE 13001	DETROIT	MI	48202	WAYNE	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	001	6	11/22/2021	COMPETING CONTINUATION	$25,450
2022	2019	WAYNE STATE UNIVERSITY	5057 WOODWARD STE 13001	DETROIT	MI	48202	WAYNE	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	000	5	11/22/2021	NON-COMPETING CONTINUATION	-$25,450
														Subtotal = $433,282

Issue Date FY: 2021 ( Subtotal = $434,120 )
2021	2021	WAYNE STATE UNIVERSITY	5057 WOODWARD STE 13001	DETROIT	MI	48202	WAYNE	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	001	6	7/14/2021	COMPETING CONTINUATION	$434,120
2021	2019	WAYNE STATE UNIVERSITY	5057 WOODWARD STE 13001	DETROIT	MI	48202	WAYNE	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	000	5	11/25/2020	NON-COMPETING CONTINUATION	$0
														Subtotal = $434,120

Issue Date FY: 2019 ( Subtotal = $336,875 )
2019	2019	WAYNE STATE UNIVERSITY	5057 WOODWARD 13 FLOOR	DETROIT	MI	48202	WAYNE	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	000	5	12/7/2018	NON-COMPETING CONTINUATION	$336,875
														Subtotal = $336,875

Issue Date FY: 2018 ( Subtotal = $336,875 )
2018	2018	WAYNE STATE UNIVERSITY	5057 WOODWARD 13 FLOOR	DETROIT	MI	48202	WAYNE	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	001	4	4/27/2018	NON-COMPETING CONTINUATION	$33,688
2018	2018	WAYNE STATE UNIVERSITY	5057 WOODWARD 13 FLOOR	DETROIT	MI	48202	WAYNE	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	000	4	11/22/2017	NON-COMPETING CONTINUATION	$303,187
														Subtotal = $336,875

Issue Date FY: 2017 ( Subtotal = $336,875 )
2017	2017	WAYNE STATE UNIVERSITY	5057 WOODWARD 13 FLOOR	DETROIT	MI	48202	WAYNE	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	001	3	6/22/2017	NON-COMPETING CONTINUATION	$33,688
2017	2017	WAYNE STATE UNIVERSITY	5057 WOODWARD 13 FLOOR	DETROIT	MI	48202	WAYNE	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	000	3	11/28/2016	NON-COMPETING CONTINUATION	$303,187
														Subtotal = $336,875

Issue Date FY: 2016 ( Subtotal = $335,235 )
2016	2016	WAYNE STATE UNIVERSITY	5700 CASS SUITE 4602	DETROIT	MI	48202	WAYNE	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	000	2	12/23/2015	NON-COMPETING CONTINUATION	$301,710
2016	2016	WAYNE STATE UNIVERSITY	5700 CASS SUITE 4602	DETROIT	MI	48202	WAYNE	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	001	2	3/3/2016	NON-COMPETING CONTINUATION	$33,525
														Subtotal = $335,235

Issue Date FY: 2015 ( Subtotal = $267,094 )
2015	2015	WAYNE STATE UNIVERSITY	5700 CASS SUITE 4602	DETROIT	MI	48202	WAYNE	USA	Extramural Research Programs in the Neurosciences and Neurological Disorders	000	1	2/3/2015	NEW	$267,094
														Subtotal = $267,094

Grand Total All Awards = $3,722,701

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Novel DWI Methods to Minimize Postoperative Deficits in Pediatric Epilepsy Surgery.

Award Number: R01NS089659

ORGANIZATION: NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 02/01/2015

PERIOD OF PERFORMANCE END DATE: 06/30/2026

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