Stereoelectroencephalography-based anatomo-electro-clinical subtyping reveals network-specific organization in
Xiaolei Song1, Tianqi Hu2, Xianying Zhao3
1Department of Neurosurgery, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050000, PR China; Hebei Medical University, Shijiazhuang, Hebei, 050017, PR China.
Aims:
This study aimed to use stereoelectroencephalography (SEEG) to delineate the anatomo-electro-clinical correlations between seizure semiology and Brodmann area-based functional subregions in parietal lobe epilepsy (PLE), so as to improve the precise localization of seizure onset and the accuracy of presurgical diagnosis.
Methods:
Patients with PLE who underwent SEEG were retrospectively included. Intracranial electrode contacts were localized based on Brodmann area (BA) anatomical divisions. Seizure semiology and ictal SEEG evolution were systematically quantified using a predefined scoring system. Hierarchical cluster analysis and principal component analysis (PCA) were applied to identify correlations between clinical signs, involved anatomical subregions, and early propagation networks.
Results:
Four distinct subtypes of PLE were identified based on the analysis of 23 patients: (1) an autonomic symptoms subtype involving BA43 and the insulo-opercular region; (2) a posterior parietal subtype centered on BA7 with contralateral versive sign and absence of autonomic symptoms; (3) a BA39-dominant subtype characterized by staring/behavioural arrest and automatisms; (4) a somatosensory subtype involving BA3.1.2 with localized somesthetic aura and no automatisms. Correlation analysis revealed a posterior-anterior gradient between semiology and BA subregions.
Conclusion:
SEEG-based subtyping reveals network-organized seizure semiology and improves the localization precision of the seizure onset zone (SOZ) in PLE.
