[Localizing target for transcranial electrical stimulation in epilepsy patients combining scalp electroencephalogram...

For patients with MRI-negative drug-resistant epilepsy, noninvasive localization of targets for transcranial electrical stimulation (tES) remains a clinical challenge. This study proposes a novel target localization approach that integrates electroencephalogram source imaging, brain network analysis, and a neural computational model. We analyzed electrocorticography (ECoG) data from 12 patients, quantified the epileptogenicity of epileptic network nodes, and noninvasively located optimal stimulation targets. Three source imaging methods and two brain network reconstruction measures were compared for localization performance. Among four patients with good outcomes, the method accurately localized epileptogenic tissues in three. Results of tES simulation demonstrated that cathodal direct current stimulation of the target region significantly reduced the brain network's epileptogenicity. This study provides a noninvasive, quantifiable targeting strategy for tES therapy in epilepsy patients.