Localization of epileptogenic zone based on graph analysis of stereo-EEG

Localization of the epileptogenic zone (EZ) is essential for the successful surgical treatment of medically intractable epilepsy. In the present study, stereo-EEG (SEEG) recordings were obtained from seven patients underwent presurgical evaluation for treatment of intractable epilepsy. Partial directed coherence (PDC) analysis was applied to construct peri-ictal effective connectivity networks. The graphic measures, in-degree, out-degree and betweenness centrality, were evaluated to localize the EZ. A receiver operating characteristic (ROC) analysis was used to quantify the localization accuracy. We found that the in-degree coincided well with the EZ identified by epileptologists' visual inspection in all seven patients who had a significant improvement in seizure outcomes, however, the other two measures were effective only in some cases. Furthermore, in all seven patients the electrode contact with the highest in-degree was always located within the EZ identified by epileptologists' visual inspection. These results indicate that the graph theory is an effective method to localize the EZ when suitable graphic measures were chosen. Furthermore, the in-degree was the most effective measure among the three graphic measures in localizing the EZ when the PDC method was used.