Predicting outcome of anterior temporal lobectomy using simulated neural networks

Purpose: Anterior temporal lobectomy (ATL) is an important option for treatment of medically refractory seizures, Patient selection is not always clear-cut, and there is inherent morbidity and mortality associated with the invasive and expensive surgical protocols. To determine whether patient selection might be facilitated by application of artifical intelligence, we developed a model that predicted seizure outcome after ATL, using a simulated neural network (SNN). Methods: Predictions of the model were compared with predictions derived from conventional discriminant function analysis. Neural networks and discriminant functions were devised that would predict the occurrence of both Class 1 outcomes (totally seizure free), and Class 1 or Class 2 outcomes (nearly or totally seizure free), using data from 87 patients from three surgical centers. The SNNs and discriminant functions were developed using data from a randomly selected subsample of 65 patients, and both models were cross-validated, using the remaining 22 patients. Results: The discriminant functions showed overall predictive accuracy of 78.5% and 72.7%, while the neural networks demonstrated overall accuracy of 81.8% and 95.4%. Conclusions: Simulated neural networks show promise as adjuncts to decision-making in the selection of epilepsy surgery patients.