In 16 HUP SEEG patients, interictal band power, spike rate, and line length separated clinical SOZ channels; aperiodic exponent did not

This partial HUP SEEG cohort tested whether nine pre-specified interictal features distinguish bipolar channels labeled as part of the clinical seizure onset zone (SOZ) from other channels within each patient. In 16 patients with SOZ labels (11 seizure-free and 5 not seizure-free), mean per-patient AUC was 0.753 for log delta power (95% bootstrap CI 0.675–0.824; Holm-adjusted sign-flip p=0.001), with AUC above 0.5 in 15/16 patients. All six log band-power features, line length (AUC 0.696), and a simplified spike rate (AUC 0.689) had Holm-adjusted p≤0.011. The 30–55 Hz aperiodic exponent did not separate SOZ from other channels (AUC 0.525, p=0.61). The power and spike-rate results persisted after removing a linear contact-index trend. Mean AUCs did not differ between seizure-free and not seizure-free groups, and resection-zone separation among seizure-free patients was weaker. These findings are limited to 16 of 39 SEEG patients, one five-minute interictal clip per patient, a simplified unvalidated spike detector, clinical SOZ labels, and no anatomical control. Higher power may reflect tissue or contact location rather than epileptogenicity.

stereo-EEG · SEEG · epilepsy · seizure onset zone · interictal · band power · spike rate · aperiodic exponent · AUC