Virtual resection evaluation based on sEEG propagation network for drug-resistant epilepsy

Area of Science:

• Neuroscience
• Computational Neuroscience
• Medical Engineering

Background:

• Drug-resistant epilepsy often necessitates surgical intervention for seizure control.
• Current surgical outcomes are limited by imprecise identification of the epileptogenic zone.
• Improved methods are needed to accurately target surgical resection for better seizure-free rates.

Purpose of the Study:

• To develop and validate a novel computational approach for identifying optimal surgical targets in drug-resistant epilepsy.
• To leverage high-order effective connectivity to map seizure propagation pathways.
• To enhance surgical planning by precisely defining the epileptogenic zone for resection.

Main Methods:

• Constructed high-order effective connectivity models to reveal epilepsy brain dynamics and propagation paths.
• Developed a control centrality evaluation scheme based on propagation paths and outdegree index for virtual resection.
• Quantified control centrality by simulating electrode removal and recalculating centrality to evaluate virtual resection schemes.
• Validated the approach using simulation, clinical, and public epilepsy datasets.

Main Results:

• Consistent results across simulation, clinical, and public datasets confirmed the method's robustness.
• Accurate seizure propagation paths were identified, revealing critical inflection points during virtual excision.
• The method identified minimum intervention targets, minimizing recurrence risk and leading to a stable brain state post-resection.
• Quantitative analysis of control centrality successfully pinpointed optimal intervention areas for epilepsy surgery.

Conclusions:

• High-order effective connectivity analysis provides a precise method for mapping epileptogenic propagation.
• Control centrality evaluation enables accurate identification of optimal surgical targets, improving intervention efficacy.
• This computational approach assists in developing more effective surgical plans for drug-resistant epilepsy, potentially increasing seizure-free rates.