Classification of Stereo-EEG Contacts in White Matter vs. Gray Matter Using Recorded Activity.

Abstract

For epileptic patients requiring resective surgery, a modality called stereo-electroencephalography (SEEG) may be used to monitor the patient's brain signals to help identify epileptogenic regions that generate and propagate seizures. SEEG involves the insertion of multiple depth electrodes into the patient's brain, each with 10 or more recording contacts along its length. However, a significant fraction (≈ 30% or more) of the contacts typically reside in white matter or other areas of the brain which can not be epileptogenic themselves. Thus, an important step in the analysis of SEEG recordings is distinguishing between electrode contacts which reside in gray matter vs. those that do not. MRI images overlaid with CT scans are currently used for this task, but they take significant amounts of time to manually annotate, and even then it may be difficult to determine the status of some contacts. In this paper we present a fast, automated method for classifying contacts in gray vs. white matter based only on the recorded signal and relative contact depth. We observe that bipolar referenced contacts in white matter have less power in all frequencies below 150 Hz than contacts in gray matter, which we use in a Bayesian classifier to attain an average area under the receiver operating characteristic curve of 0.85 ± 0.079 (SD) across 29 patients. Because our method gives a probability for each contact rather than a hard labeling, and uses a feature of the recorded signal that has direct clinical relevance, it can be useful to supplement decision-making on difficult to classify contacts or as a rapid, first-pass filter when choosing subsets of contacts from which to save recordings.