Utility of Interictal Data in Guiding Pediatric Epilepsy Surgery
Emma K Hartman1, Ethan W Ocasio1, Carolina Lopes1
1Department of Neurosurgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Pediatric Neurosurgery
|October 21, 2025
Summary
Identifying the seizure onset zone (SOZ) in pediatric epilepsy is crucial. While directed functional connectivity (FC) shows promise, current methods cannot reliably predict SOZs from interictal data alone.
Area of Science:
- Neuroscience
- Computational Neuroscience
- Medical Technology
Background:
- Accurate seizure onset zone (SOZ) localization is vital for pediatric drug-resistant epilepsy surgery.
- Current methods require invasive intracranial electroencephalography (iEEG) during seizures, leading to prolonged monitoring and complex procedures.
- Automated SOZ localization using interictal data could significantly reduce monitoring time.
Purpose of the Study:
- To review directed functional connectivity (FC) methods for preoperative SOZ localization.
- To assess the potential of these methods in predicting SOZs from interictal iEEG data.
Main Methods:
- Literature review of directed FC methodologies, including Granger Causality.
- Analysis of studies correlating FC patterns with SOZs in epilepsy patients.
Main Results:
- Directed FC methods, like Granger Causality, are evolving for graph creation.
- Several FC modalities show correlations between electrode patterns and SOZs.
- A consistent pattern of increased inward FC in SOZ electrodes during interictal periods was observed.
Conclusions:
- No current tool reliably predicts SOZs from interictal iEEG data.
- Inward FC patterns may indicate inhibitory pathways crucial for preventing epileptogenesis.
- Further analysis of directed FC changes over time is needed for optimal localization segment selection.
