Observational studyNeurology2025
Localization of the Epileptogenic Zone Using Neural Spatial Volatility in Epilepsy Surgery.
Observational study in Neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Internal and external validation of comprehensive high-frequency activity biomarkers for epilepsy surgery.Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology · 2026Article
- Localizing the epileptogenic zone in drug-resistant epilepsy based on ictal SEEG high-resolution time-frequency representation.Frontiers in neuroscience · 2026Article
- Internal and External Validation of Comprehensive High-Frequency Activity Biomarkers for Epilepsy Surgery.medRxiv : the preprint server for health sciences · 2025Article
- Ictal gamma increase shows preferential localization to seizure onset contacts in stereoelectroencephalography.Frontiers in neurologyArticle
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
BACKGROUND AND
objectivesDiseased tissues in the human brain frequently exhibit marked alterations in structural and functional properties compared with adjacent, unaffected regions, whereas healthy tissues display intrinsic, milder topographical variability in these properties. We hypothesized that the epileptogenic zone responsible for drug-resistant focal seizures would be characterized by pronounced alterations in electrographic properties relative to adjacent regions.
methodsThis international, multicenter observational study aimed to test this hypothesis by studying patients with drug-resistant focal epilepsy who underwent curative epilepsy surgery following intracranial EEG (iEEG) recording, with at least 1 year of postoperative follow-up. In this study, "neural spatial volatility" was defined as differences in interictal high-frequency electrographic measures compared with adjacent areas. We tested whether greater neural spatial volatility in resected compared to preserved sites predicts postoperative seizure freedom, independently of clinical, neuroimaging, and ictal iEEG data. In addition, we examined whether incorporating neural spatial volatility into an outcome prediction model, based on the standard-care presurgical evaluation, would improve its performance.
resultsIn a derivation cohort of 140 patients with 14,933 samples of iEEG electrodes (mean age 13.1 years; female 68 [48.6%]; postoperative seizure freedom 98 [70.0%]), greater neural spatial volatility in resected compared with preserved sites was an independent predictor of postoperative seizure freedom. The outcome prediction model considering the neural spatial volatility improved the classification performance, showing the area under the curve up to 0.825 (95% CI 0.747-0.902; DISCUSSION: Despite the limitations of the retrospective study and the relatively small validation cohort, our findings suggest that increased heterogeneity in the mesoscale distribution of interictal high-frequency activity is a distinguishing feature of the epileptogenic zone in drug-resistant focal epilepsy, potentially offering a novel marker for its localization.
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