Structural brain imaging biomarkers for predicting seizure recurrence after a first unprovoked seizure

Abstract

Objectives: Predicting seizure recurrence following a first unprovoked seizure (FUS) remains a significant clinical challenge, especially when routine clinical magnetic resonance imaging (MRI) and EEG do not reveal abnormalities diagnostic of epilepsy. Here, we incorporate quantitative structural MRI-derived biomarkers into prediction models for seizure recurrence at 12 months and identify brain structural features that are predictive of seizure recurrence. Methods: We analyzed a retrospective, multicenter cohort of 197 adult patients with FUS, comprising 83 with seizure recurrence and 114 with no seizure recurrence at 12 months. All participants had normal or nondiagnostic MRI and EEG findi..