Personalized whole brain modeling of status epilepticus

How status epilepticus (SE) is generated and propagates in the brain is not known. As for seizures, a patient-specific approach is necessary, and the analysis should be performed at the whole brain level. Personalized brain models can be used to study seizure genesis and propagation at the whole brain scale in The Virtual Brain (TVB), using the Epileptor mathematical construct. Building on the fact that SE is part of the repertoire of activities that the Epileptor can generate, we present the first attempt to model SE at the whole brain scale in TVB, using data from a patient who experienced SE during presurgical evaluation. Simulations reproduced the patterns found with SEEG recordings. We find that if, as expected, the pattern of SE propagation correlates with the properties of the patient's structural connectome, SE propagation also depends upon the global state of the network, i.e., that SE propagation is an emergent property. We conclude that individual brain virtualization can be used to study SE genesis and propagation. This type of theoretical approach may be used to design novel interventional approaches to stop SE. This paper was presented at the 8th London-Innsbruck Colloquium on Status Epilepticus and Acute Seizures held in September 2022. (c) 2023 Elsevier Inc. All rights reserved.

Automated summary

The mechanisms behind the generation and propagation of status epilepticus (SE) in the brain remain unknown. An individualized approach is needed to analyze seizures at the whole brain level. Personalized brain models using the Epileptor mathematical construct in The Virtual Brain (TVB) were used to study SE at the whole brain scale. By replicating SEEG recording patterns, the study found that SE propagation correlates with the patient's structural connectome and depends on the overall network state, highlighting its emergent property. This individual brain virtualization approach has the potential to develop novel interventional strategies to halt SE.