Identification of epileptic brain states by dynamic functional connectivity analysis of simultaneous EEG-fMRI: a...

Most fMRI studies of the brain's intrinsic functional connectivity (FC) have assumed that this is static; however, it is now clear that it changes over time. This is particularly relevant in epilepsy, which is characterized by a continuous interchange between epileptic and normal brain states associated with the occurrence of epileptic activity. Interestingly, recurrent states of dynamic FC (dFC) have been found in fMRI data using unsupervised learning techniques, assuming either their sparse or non-sparse combination. Here, we propose an l₁-norm regularized dictionary learning (l₁-DL) approach for dFC state estimation, which allows an intermediate and flexible degree of sparsity in time, and demonstrate its application in the identification of epilepsy-related dFC states using simultaneous EEG-fMRI data. With this l₁-DL approach, we aim to accommodate a potentially varying degree of sparsity upon the interchange between epileptic and non-epileptic dFC states. The simultaneous recording of the EEG is used to extract time courses representative of epileptic activity, which are incorporated into the fMRI dFC state analysis to inform the selection of epilepsy-related dFC states. We found that the proposed l₁-DL method performed best at identifying epilepsy-related dFC states, when compared with two alternative methods of extreme sparsity (k-means clustering, maximum; and principal component analysis, minimum), as well as an l₀-norm regularization framework (l₀-DL), with a fixed amount of temporal sparsity. We further showed that epilepsy-related dFC states provide novel insights into the dynamics of epileptic networks, which go beyond the information provided by more conventional EEG-correlated fMRI analysis, and which were concordant with the clinical profile of each patient. In addition to its application in epilepsy, our study provides a new dFC state identification method of potential relevance for studying brain functional connectivity dynamics in general.