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medRxiv PreprintsInternational4 November 2026

Epilepsy Lateralization by Elastic Net Regularization of a Diffusion Tensor Imaging Biomarker using Machine Learning

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Objective: Accurate lateralization of the epileptogenic focus is essential for presurgical evaluation of patients with drug-resistant epilepsy. This study examined whether diffusion tensor imaging (DTI) measures of white matter microstructure, combined with clinical and demographic variables, could classify epilepsy lateralization using machine learning. Methods: We present a retrospective analysis of 334 adult patients undergoing presurgical epilepsy evaluation at the University of Kansas Health System. Fractional anisotropy (FD) and mean diffusivity (MD) were extracted from 36 bilateral whit
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