# MRI Connectivity Biomarkers of Treatment Response in Focal Epilepsy

> **NIH NIH R01** · VANDERBILT UNIVERSITY MEDICAL CENTER · 2020 · $543,401

## Abstract

PROJECT SUMMARY
Epilepsy negatively impacts quality of life due to the seizure burden and associated depression and anxiety, in
addition to increased morbidity and mortality. Temporal lobe epilepsy (TLE) is one of the most common forms
of focal epilepsy. Anti-epileptic medication is successful in treating about 60-70% of these patients. In the
remaining patients, usually after long, unsuccessful drug trials, surgical intervention of the presumed seizure
focus leads to seizure freedom in 50-80% of patients. Therefore, more accurate early predictors of
pharmacological and surgical treatment outcome are needed to improve clinical management of these
patients. The scientific premise of this work is that while the identification of the seizure focus plays an
important role in directing management of focal epilepsy patients, the outcome of treatment (pharmacological
and surgical) is significantly influenced by the connectivity across large widespread network(s).Therefore, the
goal of this project is to develop early biomarkers of drug responsiveness and surgical outcome using MRI
functional and structural connectivity quantification. In a homogeneous group of drug refractory mesial TLE
patients whose seizure focus was presumed to be the hippocampus based on current clinical assessments,
the relationship between resting-state functional and structural network integrity in seizure propagation
networks were quantified non-invasively using MRI. These network alterations were related to disease and
cognitive characteristics before and after surgery. This allowed the development of a preliminary MRI
connectivity biomarker for post-surgical seizure outcome in mesial TLE. Building on this foundation, the
specific aims of this proposal will result in the improvement of functional and structural connectivity biomarkers
of surgical outcome in mesial TLE (Aim 1), and the development of similar biomarkers for use in other TLE
patients with seizures originating in the temporal lobe outside the mesial temporal structures (Aim 2). The
success of Aim 3 will provide a method for early identification of those who will and will not respond to anti-
epileptic medication to reduce prolonged drug trials. The overall outcome of this work will directly address the
2014 NINDS Benchmarks for Epilepsy Research section III part B: to identify biomarkers for assessing or
predicting treatment response, including markers that may identify specific populations that are likely to have
good outcomes or develop adverse responses. As such, this study has the potential to result in significantly
improved clinical management of a common debilitating disorder.

## Key facts

- **NIH application ID:** 9869054
- **Project number:** 5R01NS108445-02
- **Recipient organization:** VANDERBILT UNIVERSITY MEDICAL CENTER
- **Principal Investigator:** Victoria L Morgan
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $543,401
- **Award type:** 5
- **Project period:** 2019-02-15 → 2025-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9869054

## Citation

> US National Institutes of Health, RePORTER application 9869054, MRI Connectivity Biomarkers of Treatment Response in Focal Epilepsy (5R01NS108445-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9869054. Licensed CC0.

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