In pursuit of the epileptogenic zone in focal epilepsy: a dynamical network biomarker approach

The success of resection surgery for drug-resistant epilepsy patients hinges on the correct identification of the epileptogenic zone (EZ) consisting of the subnetwork of brain regions that underlies seizure genesis in focal epilepsy. The dynamical network biomarker (DNB) method is a dynamical systems-based network analysis approach for identifying subnetworks that are the first to exhibit the transition as a complex system undergoes a bifurcation. The approach was devised and validated in the context of complex disease onset where the dynamics is known to be nonlinear and high-dimensional. We here adapt and implement the DNB approach for the identification of the EZ from the analysis of Stereoelectroencephalography (SEEG) data. The method is first successfully tested on simulated data generated with a large-scale brain network model of epilepsy using The Virtual Brain neuroinformatic platform and then applied to clinical SEEG data from focal epilepsy patients. The results are compared with those obtained by expert clinicians that designate the EZ using the Epileptogenicity Index (EI) method. High average precision values are obtained and posit the presented approach as a promising candidate tool for the pursuit of EZ in focal epilepsy. (c) 2022 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Automated summary

The success of resection surgery for drug-resistant epilepsy patients depends on accurately identifying the epileptogenic zone (EZ), a subnetwork of brain regions responsible for seizure genesis in focal epilepsy. The dynamical network biomarker (DNB) method, originally developed for complex disease onset, is adapted and implemented for EZ identification in Stereoelectroencephalography (SEEG) data analysis. The method is validated using simulated data and compared with expert clinicians' results. The high precision values obtained suggest that the DNB approach is a promising tool for EZ identification in focal epilepsy.