Evidence map›Paper›PMID 40037091›Full record

Trial reportEBioMedicine2025

Influences of electrode density on intracranial seizure localisation: a single-blinded randomised crossover study.

Ebenezer O Chinedu-Eneh, Sharon Chiang, John P Andrews, Ehsan Tadayon, Joline M Fan, Paul A Garcia, Ernesto Gonzalez-Giraldo, Manu Hegde, Patrick Hullett, Vikram R Rao and 3 more

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in EBioMedicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Ebenezer O Chinedu-EnehDepartment of Neurology, University of California San Francisco, San Francisco, CA, USA; Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA.
Sharon ChiangDepartment of Neurology, University of California San Francisco, San Francisco, CA, USA; Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA.
John P AndrewsWeill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA; Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.
Ehsan TadayonDepartment of Neurology, Tufts University, Boston, MA, 02116, USA.
Joline M FanDepartment of Neurology, University of California San Francisco, San Francisco, CA, USA; Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA.
Paul A GarciaDepartment of Neurology, University of California San Francisco, San Francisco, CA, USA; Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA.
Ernesto Gonzalez-GiraldoDepartment of Neurology, University of California San Francisco, San Francisco, CA, USA; Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA.
Manu HegdeDepartment of Neurology, University of California San Francisco, San Francisco, CA, USA; Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA.
Patrick HullettDepartment of Neurology, University of California San Francisco, San Francisco, CA, USA; Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA.
Vikram R RaoDepartment of Neurology, University of California San Francisco, San Francisco, CA, USA; Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA.
Robert C KnowltonDepartment of Neurology, University of California San Francisco, San Francisco, CA, USA; Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA.
Edward F ChangWeill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA; Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.
Jonathan K KleenDepartment of Neurology, University of California San Francisco, San Francisco, CA, USA; Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA. Electronic address: jon.kleen@ucsf.edu.

Funding

Clinical and Translational Science InstituteUL1TR001872 · NCATS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI COLLARD, HAROLD R, JACOBY, VANESSA · 2016 to 2025
$112.1M
Hippocampal-cortical networks underlying memory retrieval of linguistic knowledgeK23NS110920 · NINDS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI KLEEN, JONATHAN · 2019 to 2023
$1.0M
Network dynamics of sleep-wake states in epilepsyK23NS125123 · NINDS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Joline Fan · 2023 to 2026
$868k
NCATS NIH HHS UL1 TR001872NINDS NIH HHS K23 NS110920NINDS NIH HHS K23 NS125123
6 · The paper itself

Abstract

backgroundSuccessful seizure onset zone (SOZ) localisation for epilepsy surgery often relies upon intracranial recordings. Accurate delineation requires anatomical detail yet influences of intracranial electrode density on clinical variables have not been systematically studied.

methodsIn this experimental study we compared SOZ localisation between spontaneously captured seizures on higher-density depth and grid electrode arrays (4-5 mm inter-electrode spacing) vs. lower-density resampled versions of those same seizures (8-10 mm spacing). Since traditional review of channel traces would reveal density conditions, we instead projected seizure activity data as heatmaps on patient brain reconstructions and hid electrode locations. Using a single-blinded randomised crossover design, six attending-level epileptologists viewed these visualisations from ten patients under both higher-density and lower-density conditions (n = 120 observations) and digitally annotated SOZs.

findingsInter-rater agreement between epileptologists on annotated margins was moderate (average Cohen's kappa: 0.47) and lower for the lower-density condition (p = 0.021, mixed effects model). Scorer confidence ratings did not differ between higher- and lower-density conditions (p = 0.410). The spatial extents of annotated SOZs for higher-density recordings were 25.4% larger on average (p = 0.011) and always closer to true SOZ extents in computer simulations, relative to lower-density.

interpretationEpileptologists using higher-density depth and subdural intracranial EEG recordings had higher inter-rater agreement and identified larger extents of SOZs compared to lower-density recordings. While further studies assessing surgical outcomes in more patients are needed, these results suggest higher densities of electrodes on already-implanted hardware may reveal sub-centimetre extensions and clearer functional contiguity of the SOZ(s) for better appraisals of pathophysiological margins in epilepsy surgery.

fundingThis work was supported by the National Institutes of Health through NINDS grant K23NS110920 and through a UCSF Weill Institute for Neurosciences Pilot Award.

Indexed as

SeizuresAdultBrainCross-Over StudiesElectrocorticographyElectrodes, ImplantedElectroencephalographyEpilepsyFemaleHumansMaleMiddle AgedSingle-Blind MethodYoung AdultDensityDepthElectrocorticographyEpilepsyGridIntracranialStereo-EEGSubdural

Identifiers

PMID40037091
PMCPMC11925122

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.