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An index to probe cortical excitability.

Roland D Widmer1, Camille G Mignardot Le Goff1, Enrique Perez-Martinez1

  • 1Sleep-wake-epilepsy center, NeuroTec, Center for experimental neurology, Department of Neurology, Inselspital Bern, University Hospital, University of Bern, Bern, Switzerland.

Journal of Neural Engineering
|March 20, 2026
PubMed
Summary

We developed a new method to measure brain excitability using stimulation-response curves from intracranial EEG. This framework quantifies cortico-cortical connection strength and provides an excitability index for clinical applications.

Keywords:
benzodiazepinecortical dynamicscortical excitabilityepilepsyinput-output relationshipneurostimulationnon-linear dynamics

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Area of Science:

  • Neuroscience
  • Computational Neuroscience
  • Systems Neuroscience

Background:

  • Cortical excitability, the brain's response to stimuli, is crucial for understanding neural function.
  • Current methods like transcranial magnetic stimulation (TMS) offer global or local probing but lack dynamic range quantification.
  • Intracranial electroencephalography (iEEG) in epilepsy patients provides a unique opportunity for detailed cortical analysis.

Purpose of the Study:

  • To establish a novel framework for quantifying cortical excitability across its dynamical range.
  • To develop a method for characterizing cortico-cortical connection strength and dynamics.
  • To introduce a practical excitability index (ExI) for comparing neural responsiveness.

Main Methods:

  • Utilized iEEG data from epilepsy patients undergoing electrical stimulation.
  • Developed a stimulation-response curve analysis framework incorporating Spearman correlation and multi-parameter fits.
  • Calculated the excitability index (ExI) as the normalized area under the stimulation-response curve.

Main Results:

  • Identified 974 effective cortico-cortical connections (34.5%) with significant correlations.
  • Demonstrated predominantly non-linear stimulation-response relationships, often requiring complex sigmoid fits.
  • Showcased the framework's clinical relevance by analyzing excitability changes pre- and post-clonazepam administration.

Conclusions:

  • Presented a robust framework for probing, measuring, and quantifying cortico-cortical connection excitability.
  • The proposed excitability index offers a standardized metric for comparing neural excitability across diverse conditions and participants.
  • This approach enhances our ability to understand and potentially modulate brain function.