Seizure forecasting by tracking cortical response to electrical stimulation.
Petroula Laiou1, Zeljko Kraljevic1, Antonio Valentin2
1Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Epilepsia
|July 15, 2025
Summary
Forecasting seizures is improved by stimulating the cortex and measuring the brain
Area of Science:
- Neuroscience
- Epilepsy Research
- Biomedical Engineering
Background:
- Seizure unpredictability significantly impacts individuals with epilepsy.
- Previous seizure forecasting relied on intracranial electroencephalography (iEEG) analysis.
- Active cortical stimulation may offer more direct insights into cortical excitability.
Purpose of the Study:
- To investigate seizure forecasting using cortical response to electrical stimulation.
- To compare this method with passive iEEG observation for seizure prediction.
Main Methods:
- Eight patients with treatment-resistant epilepsy underwent iEEG monitoring.
- Prolonged single-pulse electrical stimulation was applied to the cortex.
- A logistic regression (LR) algorithm analyzed post-stimulus iEEG responses for seizure likelihood.
Main Results:
- Seizures were forecast above chance levels in seven of eight patients (average Improvement over Chance [IoC]: 0.74).
- Forecasting performance using stimulated cortical response outperformed passive iEEG observation (average IoC: 0.54).
Conclusions:
- Cortical response to electrical stimulation shows promise for seizure forecasting.
- This approach could inform the development of novel implantable devices for seizure control.
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