Evidence map›Paper›PMID 40662337›Full record

ArticleEpilepsia2025

Seizure forecasting by tracking cortical response to electrical stimulation.

Petroula Laiou, Zeljko Kraljevic, Antonio Valentin, Sharon Jewell, Pedro F Viana, Chirag Mehra, Richard J B Dobson, Andreas Schulze-Bonhage, Matthias Dümpelmann, Timothy J Denison and 2 more

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In one paragraph

Article in Epilepsia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Article
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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

12 authors.

Petroula LaiouDepartment of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.ORCID https://orcid.org/0000-0002-5798-6961
Zeljko KraljevicDepartment of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Antonio ValentinDepartment of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.ORCID https://orcid.org/0000-0003-0449-5234
Sharon JewellDepartment of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Pedro F VianaDepartment of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.ORCID https://orcid.org/0000-0003-0861-8705
Chirag MehraDepartment of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Richard J B DobsonDepartment of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Andreas Schulze-BonhageEpilepsy Center, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.ORCID https://orcid.org/0000-0003-2382-0506
Matthias DümpelmannEpilepsy Center, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.ORCID https://orcid.org/0000-0002-1476-7777
Timothy J DenisonInstitute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, UK.
Joel S WinstonDepartment of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.ORCID https://orcid.org/0000-0002-3957-0612
Mark P RichardsonDepartment of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

Funding

MRC IAA award held by Kings College London MR/X502923/1
6 · The paper itself

Abstract

objectiveSeizure unpredictability is a significant burden in the lives of people with epilepsy. Previously published approaches to seizure forecasting analyzed intracranial electroencephalography (iEEG) recordings and showed that seizures can be forecast above chance levels. Although passive observation of the brain might provide some insights, repeated active perturbation of the cortex and measuring the cortical response may provide more direct information about time-varying cortical excitability. The aim of this study is to investigate whether seizures can be forecast by stimulating the cortex via intracranial electrodes and measuring cortical response from the iEEG.

methodsWe studied a cohort of eight patients with treatment-resistant epilepsy who were admitted to King's College Hospital for presurgical evaluation with iEEG. During their stay, they underwent prolonged single-pulse electrical stimulation for ~1 day. Stimuli were delivered every 5 min to a constant pair of electrodes, and all patients experienced at least one clinical seizure during the period of stimulation. We extracted quantitative features from the iEEG post-stimulus response and developed a LR algorithm to estimate the seizure likelihood at each stimulus. To evaluate the algorithm's performance, we used improvement over chance (IoC), sensitivity, time spent in warning, and Brier Skill Score. We also compared performance with seizure prediction based on passive observation of iEEG.

resultsIn seven of eight patients, seizures could be forecast using the post-stimulus response above chance levels (average IoC: 0.74). In comparison, the seizure forecasting performance based on passive (unstimulated) iEEG was less good (average IoC: 0.54). SIGNIFICANCE: These results suggest that cortical response to electrical stimulation may aid in the development of seizure forecasting algorithms as well as in the design of novel implantable devices that deliver electrical stimulation to control seizures.

Indexed as

Cerebral CortexDrug Resistant EpilepsyElectric StimulationElectrocorticographySeizuresAdolescentAdultAlgorithmsCohort StudiesElectrodes, ImplantedElectroencephalographyFemaleForecastingHumansMaleMiddle Agedcortical responseelectrical stimulationepilepsyforecastingintracranial electroencephalographic recordingsseizures

Identifiers

PMID40662337
PMCPMC12611449

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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.