Stereo-electroencephalography Signals Research Articles

Functional mapping of movement and speech using task-based electrophysiological changes in stereoelectroencephalography.

Stereoelectroencephalography (SEEG) has become the predominant method for intracranial seizure localization. When imaging, semiology, and scalp EEG findings are not in full agreement or definitively localizing, implanted SEEG recordings are used to test candidate seizure onset zones (SOZs). Discovered SOZs may then be targeted for resection, laser ablation, or neurostimulation. If an SOZ is eloquent, resection and ablation are both contraindicated, so identifying functional representation is crucial for therapeutic decision-making. The authors present a novel functional brain mapping technique that utilizes task-based electrophysiological changes in SEEG during behavioral tasks and test this in pediatric and adult patients. SEEG was recorded in 20 patients with epilepsy who ranged in age from 6 to 39 years (12 female, 18 of 20 patients < 21 years of age) and underwent implanted monitoring to identify seizure onset. Each performed 1) visually cued simple repetitive movements of the hand, foot, or tongue while electromyography was recorded; and 2) simple picture-naming or verb-generation speech tasks while audio was recorded. Broadband changes in the power spectrum of the SEEG recording were compared between behavior and rest. Electrophysiological functional mapping of movement and/or speech areas was completed in all 20 patients. Eloquent representation was identified in both cortex and white matter and generally corresponded to classically described functional anatomical organization as well as other clinical mapping results. Robust maps of brain activity were identified in healthy brain, regions of developmental or acquired structural abnormality, and SOZs. Task-based electrophysiological mapping using broadband changes in the SEEG signal reliably identifies movement and speech representation in pediatric and adult epilepsy patients.

Combining independent component analysis and source localization for improving spatial sampling of stereoelectroencephalography in epilepsy

Stereoelectroencephalography is a powerful intracerebral EEG recording method for the presurgical evaluation of epilepsy. It consists in implanting depth electrodes in the patient’s brain to record electrical activity and map the epileptogenic zone, which should be resected to render the patient seizure-free. Stereoelectroencephalography has high spatial accuracy and signal-to-noise ratio but remains limited in the coverage of the explored brain regions. Thus, the implantation might provide a suboptimal sampling of epileptogenic regions. We investigate the potential of improving a suboptimal stereoelectroencephalography recording by performing source localization on stereoelectroencephalography signals. We propose combining independent component analysis, connectivity measures to identify components of interest, and distributed source modelling. This approach was tested on two patients with two implantations each, the first failing to characterize the epileptogenic zone and the second giving a better diagnosis. We demonstrate that ictal and interictal source localization performed on the first stereoelectroencephalography recordings matches the findings of the second stereo-EEG exploration. Our findings suggest that independent component analysis followed by source localization on the topographies of interest is a promising method for retrieving the epileptogenic zone in case of suboptimal implantation.

Data augmentation for invasive brain–computer interfaces based on stereo-electroencephalography (SEEG)

Objective. Deep learning is increasingly used for brain–computer interfaces (BCIs). However, the quantity of available data is sparse, especially for invasive BCIs. Data augmentation (DA) methods, such as generative models, can help to address this sparseness. However, all the existing studies on brain signals were based on convolutional neural networks and ignored the temporal dependence. This paper attempted to enhance generative models by capturing the temporal relationship from a time-series perspective. Approach. A conditional generative network (conditional transformer-based generative adversarial network (cTGAN)) based on the transformer model was proposed. The proposed method was tested using a stereo-electroencephalography (SEEG) dataset which was recorded from eight epileptic patients performing five different movements. Three other commonly used DA methods were also implemented: noise injection (NI), variational autoencoder (VAE), and conditional Wasserstein generative adversarial network with gradient penalty (cWGANGP). Using the proposed method, the artificial SEEG data was generated, and several metrics were used to compare the data quality, including visual inspection, cosine similarity (CS), Jensen–Shannon distance (JSD), and the effect on the performance of a deep learning-based classifier. Main results. Both the proposed cTGAN and the cWGANGP methods were able to generate realistic data, while NI and VAE outputted inferior samples when visualized as raw sequences and in a lower dimensional space. The cTGAN generated the best samples in terms of CS and JSD and outperformed cWGANGP significantly in enhancing the performance of a deep learning-based classifier (each of them yielding a significant improvement of 6% and 3.4%, respectively). Significance. This is the first time that DA methods have been applied to invasive BCIs based on SEEG. In addition, this study demonstrated the advantages of the model that preserves the temporal dependence from a time-series perspective.

Channel Selection for Stereo-electroencephalography (SEEG)-based Invasive Brain-Computer Interfaces using Deep Learning Methods.

Brain-computer interfaces (BCIs) can enable direct communication with assistive devices by recording and decoding signals from the brain. To achieve high performance, many electrodes will be used, such as the recently developed invasive BCIs with channel numbers up to hundreds or even thousands. For those high-throughput BCIs, channel selection is important to reduce signal redundancy and invasiveness while maintaining decoding performance. However, such endeavour is rarely reported for invasive BCIs, especially those using deep learning methods. Two deep learning-based methods, referred to as Gumbel and STG, were proposed in this paper. They were evaluated using the Stereo-electroencephalography (SEEG) signals, and compared with three other methods, including manual selection, mutual information-based method (MI), and all channels (all channels without selection). The task is to classify the SEEG signals into five movements using channels selected by each method. When 10 channels were selected, the mean classification accuracies using Gumbel, STG (referred to as STG-10), manual selection, and MI selection were 65%, 60%, 60%, and 47%, respectively, whilst the accuracy was 59% using all channels (no selection). In addition, an investigation of the selected channels showed that Gumbel and STG have successfully identified the pre-central and post-central areas, which are closely related to motor control. Both Gumbel and STG successfully selected the informative channels in SEEG recordings while maintaining decoding accuracy. This study enables future high-throughput BCIs using deep learning methods, to identify useful channels and reduce computing and wireless transmission pressure.

Predicting radiofrequency thermocoagulation surgical outcomes in refractory focal epilepsy patients using functional coupled neural mass model.

The success rate of achieving seizure freedom after radiofrequency thermocoagulation surgery for patients with refractory focal epilepsy is about 20-40%. This study aims to enhance the prediction of surgical outcomes based on preoperative decisions through network model simulation, providing a reference for clinicians to validate and optimize surgical plans. Twelve patients with epilepsy who underwent radiofrequency thermocoagulation were retrospectively reviewed in this study. A coupled model based on model subsets of the neural mass model was constructed by calculating partial directed coherence as the coupling matrix from stereoelectroencephalography (SEEG) signals. Multi-channel time-varying model parameters of excitation and inhibitions were identified by fitting the real SEEG signals with the coupled model. Further incorporating these model parameters, the coupled model virtually removed contacts destroyed in radiofrequency thermocoagulation or selected randomly. Subsequently, the coupled model after virtual surgery was simulated. The identified excitatory and inhibitory parameters showed significant difference before and after seizure onset (p < 0.05), and the trends of parameter changes aligned with the seizure process. Additionally, excitatory parameters of epileptogenic contacts were higher than that of non-epileptogenic contacts, and opposite findings were noticed for inhibitory parameters. The simulated signals of postoperative models to predict surgical outcomes yielded an area under the curve (AUC) of 83.33% and an accuracy of 91.67%. The multi-channel coupled model proposed in this study with physiological characteristics showed a desirable performance for preoperatively predicting patients' prognoses.

Single-pulse electrical stimulation artifact removal using the novel matching pursuit-based artifact reconstruction and removal method (MPARRM)

Objective. Single-pulse electrical stimulation (SPES) has been widely used to probe effective connectivity. However, analysis of the neural response is often confounded by stimulation artifacts. We developed a novel matching pursuit-based artifact reconstruction and removal method (MPARRM) capable of removing artifacts from stimulation-artifact-affected electrophysiological signals. Approach. To validate MPARRM across a wide range of potential stimulation artifact types, we performed a bench-top experiment in which we suspended electrodes in a saline solution to generate 110 types of real-world stimulation artifacts. We then added the generated stimulation artifacts to ground truth signals (stereoelectroencephalography signals from nine human subjects recorded during a receptive speech task), applied MPARRM to the combined signal, and compared the resultant denoised signal with the ground truth signal. We further applied MPARRM to artifact-affected neural signals recorded from the hippocampus while performing SPES on the ipsilateral basolateral amygdala in nine human subjects. Main results. MPARRM could remove stimulation artifacts without introducing spectral leakage or temporal spread. It accommodated variable stimulation parameters and recovered the early response to SPES within a wide range of frequency bands. Specifically, in the early response period (5–10 ms following stimulation onset), we found that the broadband gamma power (70–170 Hz) of the denoised signal was highly correlated with the ground truth signal ( R=0.98±0.02 , Pearson), and the broadband gamma activity of the denoised signal faithfully revealed the responses to the auditory stimuli within the ground truth signal with 94%±1.47% sensitivity and 99%±1.01% specificity. We further found that MPARRM could reveal the expected temporal progression of broadband gamma activity along the anterior-posterior axis of the hippocampus in response to the ipsilateral amygdala stimulation. Significance. MPARRM could faithfully remove SPES artifacts without confounding the electrophysiological signal components, especially during the early-response period. This method can facilitate the understanding of the neural response mechanisms of SPES.

Deep Learning With Convolutional Neural Networks for Motor Brain-Computer Interfaces Based on Stereo-Electroencephalography (SEEG).

Deep learning based on convolutional neural networks (CNN) has achieved success in brain-computer interfaces (BCIs) using scalp electroencephalography (EEG). However, the interpretation of the so-called 'black box' method and its application in stereo-electroencephalography (SEEG)-based BCIs remain largely unknown. Therefore, in this paper, an evaluation is performed on the decoding performance of deep learning methods on SEEG signals. Thirty epilepsy patients were recruited, and a paradigm including five hand and forearm motion types was designed. Six methods, including filter bank common spatial pattern (FBCSP) and five deep learning methods (EEGNet, shallow and deep CNN, ResNet, and a deep CNN variant named STSCNN), were used to classify the SEEG data. Various experiments were conducted to investigate the effect of windowing, model structure, and the decoding process of ResNet and STSCNN. The average classification accuracy for EEGNet, FBCSP, shallow CNN, deep CNN, STSCNN, and ResNet were 35 ± 6.1%, 38 ± 4.9%, 60 ± 3.9%, 60 ± 3.3%, 61 ± 3.2%, and 63 ± 3.1% respectively. Further analysis of the proposed method demonstrated clear separability between different classes in the spectral domain. ResNet and STSCNN achieved the first- and second-highest decoding accuracy, respectively. The STSCNN demonstrated that an extra spatial convolution layer was beneficial, and the decoding process can be partially interpreted from spatial and spectral perspectives. This study is the first to investigate the performance of deep learning on SEEG signals. In addition, this paper demonstrated that the so-called 'black-box' method can be partially interpreted.

PO036 / #609 REFINEMENT OF GRANULARITY OF CORTICAL ATLAS TO MODEL EPILEPTIC INTERICTAL SPIKE PROPAGATION: E-POSTER VIEWING

In patients with drug-resistant partial epilepsy, intracerebral recordings with stereoelectroencephalography (SEEG) are performed in order to localize the activity arising from epileptogenic tissues and its propagation patterns. The clinical interpretation of SEEG signals is crucial to delimit surgery boundaries or to design patient-specific neuromodulation protocols. To assist these interpretations, physiologically relevant computational and anatomical models can be combined to reconstruct in silico intracerebral SEEG signals and to link the signal morphology with the geometry of underlying epileptic regions.

Signal processing and computational modeling for interpretation of SEEG-recorded interictal epileptiform discharges in epileptogenic and non-epileptogenic zones

Objective. In partial epilepsies, interictal epileptiform discharges (IEDs) are paroxysmal events observed in epileptogenic zone (EZ) and non-epileptogenic zone (NEZ). IEDs’ generation and recurrence are subject to different hypotheses: they appear through glutamatergic and gamma-aminobutyric acidergic (GABAergic) processes; they may trigger seizures or prevent seizure propagation. This paper focuses on a specific class of IEDs, spike-waves (SWs), characterized by a short-duration spike followed by a longer duration wave, both of the same polarity. Signal analysis and neurophysiological mathematical models are used to interpret puzzling IED generation. Approach. Interictal activity was recorded by intracranial stereo-electroencephalography (SEEG) electrodes in five different patients. SEEG experts identified the epileptic and non-epileptic zones in which IEDs were detected. After quantifying spatial and temporal features of the detected IEDs, the most significant features for classifying epileptic and non-epileptic zones were determined. A neurophysiologically-plausible mathematical model was then introduced to simulate the IEDs and understand the underlying differences observed in epileptic and non-epileptic zone IEDs. Main results. Two classes of SWs were identified according to subtle differences in morphology and timing of the spike and wave component. Results showed that type-1 SWs were generated in epileptogenic regions also involved at seizure onset, while type-2 SWs were produced in the propagation or non-involved areas. The modeling study indicated that synaptic kinetics, cortical organization, and network interactions determined the morphology of the simulated SEEG signals. Modeling results suggested that the IED morphologies were linked to the degree of preserved inhibition. Significance. This work contributes to the understanding of different mechanisms generating IEDs in epileptic networks. The combination of signal analysis and computational models provides an efficient framework for exploring IEDs in partial epilepsies and classifying EZ and NEZ.

E2SGAN: EEG-to-SEEG translation with generative adversarial networks.

High-quality brain signal data recorded by Stereoelectroencephalography (SEEG) electrodes provide clinicians with clear guidance for presurgical assessments for epilepsy surgeries. SEEG, however, is limited to selected patients with epilepsy due to its invasive procedure. In this work, a brain signal synthesis framework is presented to synthesize SEEG signals from non-invasive EEG signals. First, a strategy to determine the matching relation between EEG and SEEG channels is presented by considering both signal correlation and spatial distance. Second, the EEG-to-SEEG generative adversarial network (E2SGAN) is proposed to precisely synthesize SEEG data from the simultaneous EEG data. Although the widely adopted magnitude spectra has proved to be informative in EEG tasks, it leaves much to be desired in the setting of signal synthesis. To this end, instantaneous frequency spectra is introduced to further represent the alignment of the signal. Correlative spectral attention (CSA) is proposed to enhance the discriminator of E2SGAN by capturing the correlation between each pair of EEG and SEEG frequencies. The weighted patch prediction (WPP) technique is devised to ensure robust temporal results. Comparison experiments on real-patient data demonstrate that E2SGAN outperforms baseline methods in both temporal and frequency domains. The perturbation experiment reveals that the synthesized results have the potential to capture abnormal discharges in epileptic patients before seizures.

Electrode–brain interface fractional order modelling for brain tissue classification in SEEG

Epileptic patients with drug resistant epilepsy can undergo invasive stereoelectroencephalography (SEEG) examination in order to identify the epileptic zone to be removed with surgery. The correct classification of the brain tissue the electrodes are inserted in is decisive for the final clinical decision. The objective of this paper is to explore differences in brain tissue via the modelling of the brain electrode interface from SEEG recordings. The proposed model is based on the physical properties of the electrode–brain interface already presented in literature, and considers the voltage of three consecutive SEEG contacts. An identification algorithm is proposed considering constraints from the physical model and prior knowledge of the values of the components and a non-parametric study. Parameter models are identified using the data of 19 different patients, and validated by visual inspection and cross-correlation tests. Differences in the resistance of white and grey matter are observed using the coefficients of the identified models. From this coefficients, an accuracy of 73±6% is achieved for heterogeneous tissue classification of triplets of contacts. The information obtained from the study of the electrode-brain interface using typical SEEG signals proposed in this paper can be used to estimate tissue composition between triplets of consecutive SEEG contacts.

Decoding continuous kinetic information of grasp from stereo-electroencephalographic (SEEG) recordings

Objective. Brain–computer interfaces (BCIs) have the potential to bypass damaged neural pathways and restore functionality lost due to injury or disease. Approaches to decoding kinematic information are well documented; however, the decoding of kinetic information has received less attention. Additionally, the possibility of using stereo-electroencephalography (SEEG) for kinetic decoding during hand grasping tasks is still largely unknown. Thus, the objective of this paper is to demonstrate kinetic parameter decoding using SEEG in patients performing a grasping task with two different force levels under two different ascending rates. Approach. Temporal-spectral representations were studied to investigate frequency modulation under different force tasks. Then, force amplitude was decoded from SEEG recordings using multiple decoders, including a linear model, a partial least squares model, an unscented Kalman filter, and three deep learning models (shallow convolutional neural network, deep convolutional neural network and the proposed CNN+RNN neural network). Main results. The current study showed that: (a) for some channel, both low-frequency modulation (event-related desynchronization (ERD)) and high-frequency modulation (event-related synchronization) were sustained during prolonged force holding periods; (b) continuously changing grasp force can be decoded from the SEEG signals; (c) the novel CNN+RNN deep learning model achieved the best decoding performance, with the predicted force magnitude closely aligned to the ground truth under different force amplitudes and changing rates. Significance. This work verified the possibility of decoding continuously changing grasp force using SEEG recordings. The result presented in this study demonstrated the potential of SEEG recordings for future BCI application.

Spontaneous State Detection Using Time-Frequency and Time-Domain Features Extracted From Stereo-Electroencephalography Traces.

As a minimally invasive recording technique, stereo-electroencephalography (SEEG) measures intracranial signals directly by inserting depth electrodes shafts into the human brain, and thus can capture neural activities in both cortical layers and subcortical structures. Despite gradually increasing SEEG-based brain-computer interface (BCI) studies, the features utilized were usually confined to the amplitude of the event-related potential (ERP) or band power, and the decoding capabilities of other time-frequency and time-domain features have not been demonstrated for SEEG recordings yet. In this study, we aimed to verify the validity of time-domain and time-frequency features of SEEG, where classification performances served as evaluating indicators. To do this, using SEEG signals under intermittent auditory stimuli, we extracted features including the average amplitude, root mean square, slope of linear regression, and line-length from the ERP trace and three traces of band power activities (high-gamma, beta, and alpha). These features were used to detect the active state (including activations to two types of names) against the idle state. Results suggested that valid time-domain and time-frequency features distributed across multiple regions, including the temporal lobe, parietal lobe, and deeper structures such as the insula. Among all feature types, the average amplitude, root mean square, and line-length extracted from high-gamma (60–140 Hz) power and the line-length extracted from ERP were the most informative. Using a hidden Markov model (HMM), we could precisely detect the onset and the end of the active state with a sensitivity of 95.7 ± 1.3% and a precision of 91.7 ± 1.6%. The valid features derived from high-gamma power and ERP in this work provided new insights into the feature selection procedure for further SEEG-based BCI applications.

Generation of synthetic training data for SEEG electrodes segmentation.

Stereoelectroencephalography (SEEG) is a minimally invasive surgical procedure, used to locate epileptogenic zones. An accurate identification of the metallic contacts recording the SEEG signal is crucial to ensure effectiveness of the upcoming treatment. However, due to the presence of metal, post-operative CT scans contain strong streak artefacts that interfere with deep learning segmentation algorithms and require a lot of training data to distinguish from actual contacts. We propose a method to generate synthetic data and use them to train a neural network to precisely locate SEEG electrode contacts. Random electrodes were generated following manufacturer's specifications and dimensions and placed in acceptable regions inside metal-free CT images. Metal artefacts were simulated in the generated data set using radon transform, beam hardening, and filtered back projection. A UNet neural network was trained for the contacts segmentation task using various training set-ups combining real data, basic augmented data, and synthetic data. The results were compared. We reported a higher accuracy when including synthetic data during the network training, while training only on real and basic augmented data more often led to misclassified artefacts or missed contacts. The network segments post-operative CT slices in less than 2 s using 4 GeForce RTX2080 Ti GPUs and in under a minute using a standard PC with GeForce GTX1060. Using synthetic data to train the network significantly improves contact detection and segmentation accuracy.

Automatic Electrophysiological Noise Reduction and Epileptic Seizure Detection for Stereoelectroencephalography.

The objective of this study was to develop a computational algorithm capable of locating artifacts and identifying epileptic seizures, which specifically implementing in clinical stereoelectroencephalography (SEEG) recordings. Based on the nonstationary nature and broadband features of SEEG signals, a comprehensive strategy combined with the complex wavelet transform (CWT) and multi-layer thresholding method was implemented for both noise reduction and seizure detection. The artifacts removal pipeline integrated edge artifact removal, discrete spectrum analysis, and peak density evaluation. For automatic seizure detection, integrated power analysis and multi-dynamic thresholding were applied. The F1score was applied to evaluate overall performance of the algorithm. The algorithm was tested using expert-marked, double-blinded, clinical SEEG data from seven patients undergoing presurgical evaluation. This approach achieved the F1 score of 0.86 for noise reduction and 0.88 for seizure detection. This offline-approach method with minimum parameter tuning procedures and no prior information required, proved to be a feasible and solid solution for clinical SEEG data evaluation. Moreover, the algorithm can be improved with additional tuning and implemented with machine learning postprocessing pipelines.

Investigating Data Cleaning Methods to Improve Performance of Brain-Computer Interfaces Based on Stereo-Electroencephalography.

Stereo-electroencephalography (SEEG) utilizes localized and penetrating depth electrodes to directly measure electrophysiological brain activity. The implanted electrodes generally provide a sparse sampling of multiple brain regions, including both cortical and subcortical structures, making the SEEG neural recordings a potential source for the brain–computer interface (BCI) purpose in recent years. For SEEG signals, data cleaning is an essential preprocessing step in removing excessive noises for further analysis. However, little is known about what kinds of effect that different data cleaning methods may exert on BCI decoding performance and, moreover, what are the reasons causing the differentiated effects. To address these questions, we adopted five different data cleaning methods, including common average reference, gray–white matter reference, electrode shaft reference, bipolar reference, and Laplacian reference, to process the SEEG data and evaluated the effect of these methods on improving BCI decoding performance. Additionally, we also comparatively investigated the changes of SEEG signals induced by these different methods from multiple-domain (e.g., spatial, spectral, and temporal domain). The results showed that data cleaning methods could improve the accuracy of gesture decoding, where the Laplacian reference produced the best performance. Further analysis revealed that the superiority of the data cleaning method with excellent performance might be attributed to the increased distinguishability in the low-frequency band. The findings of this work highlighted the importance of applying proper data clean methods for SEEG signals and proposed the application of Laplacian reference for SEEG-based BCI.

Changes in epileptogenicity biomarkers after stereotactic thermocoagulation.

Stereo-electroencephalography (SEEG)-guided radiofrequency thermocoagulation (RF-TC) aims at modifying epileptogenic networks to reduce seizure frequency. High-frequency oscillations (HFOs), spikes, and cross-rate are quantifiable epileptogenic biomarkers. In this study, we sought to evaluate, using SEEG signals recorded before and after thermocoagulation, whether a variation in these markers is related to the therapeutic effect of this procedure and to the outcome of surgery. Interictal segments of SEEG signals were analyzed in 38 patients during presurgical evaluation. We used an automatized method to quantify the rate of spikes, rate of HFOs, and cross-rate (a measure combining spikes and HFOs) before and after thermocoagulation. We analyzed the differences both at an individual level with a surrogate approach and at a group level with analysis of variance. We then evaluated the correlation between these variations and the clinical response to RF-TC and to subsequent resective surgery. After thermocoagulation, 19 patients showed a clinical improvement. At the individual level, clinically improved patients more frequently had a reduction in spikes and cross-rate in the epileptogenic zone than patients without clinical improvement (p=.002, p=.02). At a group level, there was a greater decrease of HFOs in epileptogenic and thermocoagulated zones in patients with clinical improvement (p<.05) compared to those with no clinical benefit. Eventually, a significant decrease of all the markers after RF-TC was found in patients with a favorable outcome of resective surgery (spikes, p=.026; HFOs, p=.03; cross-rate, p=.03). Quantified changes in the rate of spikes, rate of HFOs, and cross-rate can be observed after thermocoagulation, and the reduction of these markers correlates with a favorable clinical outcome after RF-TC and with successful resective surgery. This may suggest that interictal biomarker modifications after RF-TC can be clinically used to predict the effectiveness of the thermocoagulation procedure and the outcome of resective surgery.

Self-Related Stimuli Decoding With Auditory and Visual Modalities Using Stereo-Electroencephalography.

Name recognition plays important role in self-related cognitive processes and also contributes to a variety of clinical applications, such as autism spectrum disorder diagnosis and consciousness disorder analysis. However, most previous name-related studies usually adopted noninvasive EEG or fMRI recordings, which were limited by low spatial resolution and temporal resolution, respectively, and thus millisecond-level response latencies in precise brain regions could not be measured using these noninvasive recordings. By invasive stereo-electroencephalography (SEEG) recordings that have high resolution in both the spatial and temporal domain, the current study distinguished the neural response to one's own name or a stranger's name, and explored common active brain regions in both auditory and visual modalities. The neural activities were classified using spatiotemporal features of high-gamma, beta, and alpha band. Results showed that different names could be decoded using multi-region SEEG signals, and the best classification performance was achieved at high gamma (60–145 Hz) band. In this case, auditory and visual modality-based name classification accuracies were 84.5 ± 8.3 and 79.9 ± 4.6%, respectively. Additionally, some single regions such as the supramarginal gyrus, middle temporal gyrus, and insula could also achieve remarkable accuracies for both modalities, supporting their roles in the processing of self-related information. The average latency of the difference between the two responses in these precise regions was 354 ± 63 and 285 ± 59 ms in the auditory and visual modality, respectively. This study suggested that name recognition was attributed to a distributed brain network, and the subsets with decoding capabilities might be potential implanted regions for awareness detection and cognition evaluation.

Focal polymicrogyria in children: Contribution of invasive explorations and epileptogenicity mapping in the surgical decision

ObjectiveReport of the contribution of invasive EEG (iEEG) and epileptogenicity mappings (EM) in a pediatric cohort of patients with epilepsy associated with focal polymicrogyria (PMG) and candidates for resective surgery. MethodRetrospective pediatric case series of patients presenting focal PMG-related refractory epilepsy undergoing an invasive exploration (iEEG) at Fondation Rothschild Hospital. We reviewed clinical data, structural MRI, and visual analysis of iEEG recordings. Moreover, time-frequency analysis of SEEG signals with a neuroimaging approach (epileptogenicity maps) was used to support visual analysis. ResultsBetween 2012 and 2019, eight patients were selected. Five patients were explored with stereoelectroencephalography (SEEG) only, one patient with subdural exploration (SDE) only and two patients first underwent SEEG and then SDE.The mean age at seizure onset was 40.3 months (range 3–120), and the mean age for the iEEG 10.8 years (range 7–15). The epileptogenic zone (EZ) appeared concordant to the PMG lesion in only one case, was larger in three cases, smaller in two cases and different in one case. Four cases were selected for tailored resective surgery and one for total callosotomy. Two patients remained seizure-free at their last follow-up (mean 32.6 months, range 7–98). Epileptogenicity mapping (EM) refined the qualitative analysis, showing in four patients an EZ larger than visually defined. ConclusionThis study is the first pediatric study to analyze the value of iEEG and EM as well as operability in focal PMG-related refractory epilepsy. The results illustrate the complexity of this pathology with variable concordance between the EZ and the lesion and mixed response to surgery.

Extracting seizure onset from surface EEG with independent component analysis: Insights from simultaneous scalp and intracerebral EEG

The success of stereoelectroencephalographic (SEEG) investigations depends crucially on the hypotheses on the putative location of the seizure onset zone. This information is derived from non-invasive data either based on visual analysis or advanced source localization algorithms. While source localization applied to interictal spikes recorded on scalp is the classical method, it does not provide unequivocal information regarding the seizure onset zone. Raw ictal activity contains a mixture of signals originating from several regions of the brain as well as EMG artifacts, hampering direct input to the source localization algorithms. We therefore introduce a methodology that disentangles the various sources contributing to the scalp ictal activity using independent component analysis and uses equivalent current dipole localization as putative locus of ictal sources. We validated the results of our analysis pipeline by performing long-term simultaneous scalp – intracerebral (SEEG) recordings in 14 patients and analyzing the wavelet coherence between the independent component encoding the ictal discharge and the SEEG signals in 8 patients passing the inclusion criteria. Our results show that invasively recorded ictal onset patterns, including low-voltage fast activity, can be captured by the independent component analysis of scalp EEG. The visibility of the ictal activity strongly depends on the depth of the sources. The equivalent current dipole localization can point to the seizure onset zone (SOZ) with an accuracy that can be as high as 10 mm for superficially located sources, that gradually decreases for deeper seizure generators, averaging at 47 mm in the 8 analyzed patients. Independent component analysis is therefore shown to have a promising SOZ localizing value, indicating whether the seizure onset zone is neocortical, and its approximate location, or located in mesial structures. That may contribute to a better crafting of the hypotheses used as basis of the stereo-EEG implantations.