In HUP SEEG, an ictal EI-like map marked clinical SOZ pairs but did not separate surgical outcome groups

This study asked whether overlap between an ictal high-frequency onset map and treated contacts distinguishes surgical outcomes in SEEG. In 36 outcome-eligible HUP patients from OpenNeuro ds004100 (20 seizure-free, 16 not seizure-free; one seizure per patient), an Epileptogenicity-Index-like (EI-like) map marked clinical seizure-onset-zone (SOZ) pairs (mean within-patient AUC 0.642; 26/36 above 0.5; sign-flip p=0.00018). However, the fraction of EI-high pairs that were resected had outcome AUC 0.527 (p=0.7869), and the EI-like AUC for resected pairs had outcome AUC 0.547 (p=0.6508). A high-frequency-rise feature and the clinical SOZ resected fraction also did not separate outcomes. In the resection-only subset (7 seizure-free, 4 not), comparisons were not significant (p≥0.48). The sample has low power for moderate effects. One seizure per patient, a 45-second window, untuned EI parameters, clinical labels, and coarse contact-level treatment labels, especially for laser ablation, limit interpretation. The null result does not establish absence of an effect.

stereo-electroencephalography · SEEG · epilepsy surgery · ictal onset · epileptogenicity index · seizure-onset zone · surgical outcome