Machine learning on interictal intracranial EEG predicts surgical outcome in drug resistant epilepsy

Surgical success for patients with focal drug resistant epilepsy (DRE) relies on accurate localization of the epileptogenic zone (EZ). Currently, no exam delineates this zone unambiguously. Instead, the EZ is approximated by the area where seizures begin, which is identified manually through a tedious process that is prone to errors and biases. More importantly, resection of this area does not always predict good surgical outcome. Here, we propose an artificially intelligent, patient-specific framework that automatically identifies the EZ requiring little to no input from clinicians, without having to wait for a seizure to occur. The framework transforms interictal intracranial electroencephalography data into spatiotemporal representations of brain activity discriminating the interictal epileptogenic network from background activity. The epileptogenic network delineates the EZ with high precision and predicts surgical outcome. Our framework eliminates the need for manual data inspection, reduces prolonged monitoring, and enhances surgical planning for DRE patients.