Intracranial EEG Structure-Function Coupling and Seizure Outcomes After Epilepsy Surgery
Nishant Sinha1, John S Duncan2, Beate Diehl2
1From the Department of Neurology (N.S., K.A.D.), Penn Epilepsy Center, Perelman School of Medicine, and Center for Neuroengineering and Therapeutics (N.S., K.A.D.), University of Pennsylvania, Philadelphia; Translational and Clinical Research Institute (Y.W., P.N.T.), Faculty of Medical Sciences, and Computational Neuroscience, Neurology, and Psychiatry Lab (Y.W., P.N.T.), ICOS Group, School of Computing, Newcastle University; Department of Epilepsy (J.S.D., B.D., F.A.C., J.d.T., A.M., A.W.M., G.P.W., Y.W., P.N.T.), UCL Queen Square Institute of Neurology; UCL Centre for Medical Image Computing (S.B.V.); Neuroradiological Academic Unit (S.B.V.), UCL Queen Square Institute of Neurology, London; MRI Unit (J.S.D., G.P.W.), Chalfont Centre for Epilepsy, Bucks, United Kingdom; Centre for Microscopy, Characterisation, and Analysis (S.B.V.), The University of Western Australia, Nedlands; and Division of Neurology (G.P.W.), Department of Medicine, Queen's University, Kingston, Canada. nishant.sinha@pennmedicine.upenn.edu peter.taylor@newcastle.ac.uk.
Stronger brain structure-function coupling predicts successful epilepsy surgery outcomes. This finding can improve patient selection and surgical planning for drug-resistant epilepsy, enhancing seizure control.
Area of Science:
- Neuroscience
- Neurosurgery
- Medical Imaging
Background:
- Drug-resistant epilepsy necessitates surgical intervention to control seizures by altering brain networks.
- Understanding the relationship between brain structure and function is crucial for optimizing surgical success.
Purpose of the Study:
- To investigate the correlation between brain structure-function connectivity and surgical outcomes in epilepsy.
- To determine if quantifying this coupling can predict seizure freedom post-surgery.
Main Methods:
- Constructed functional and structural brain networks using intracranial EEG (iEEG) and MRI data.
- Quantified structure-function coupling at global and individual electrode levels.
- Developed a predictive model incorporating coupling metrics and clinical variables for seizure freedom.
Main Results:
- Stronger structure-function coupling in implanted brain areas correlated with seizure freedom (AUC=0.78).
- Virtual surgeries on areas with high coupling predicted seizure-free outcomes (AUC=0.73).
- Combined coupling measures and clinical data achieved high predictive accuracy (AUC=0.91, 92% accuracy).
Conclusions:
- Structure-function connectivity coupling is a key predictor of epilepsy surgery success.
- Integrating coupling measures into presurgical evaluation can enhance localization of epileptogenic tissue and patient selection.
