In 34 SEEG patients, resection overlap with high NREM delta-phase coupling or high-frequency activity did not differ by seizure outcome

We tested whether the overlap between resection and high-marker stereoelectroencephalography (SEEG) bipolar pairs was greater in seizure-free (ILAE 1) than in non-seizure-free (ILAE 2–6) patients. A preregistered analysis used 30–120 s NREM epochs from OpenNeuro ds007118, ds007119, and ds007120 (version 1.0.0). Among 34 patients with both resected and non-resected pairs and an ILAE outcome (17 per outcome group), the seizure-free minus non-seizure-free difference in mean patient-level resection AUC was +0.038 for delta-phase/80–300 Hz amplitude modulation index (MI; 95% CI −0.128 to 0.199; Holm-adjusted p = 1.0) and −0.019 for 80–300 Hz high-frequency activity power (HFA; 95% CI −0.203 to 0.163; Holm-adjusted p = 1.0). The preregistered decision rule was not met. Secondary analyses across cohorts, complete SOZ resection strata, a stricter patient subset, a second time window, and delta power did not change this result. Pooled MI resection AUC was 0.661 (p = 0.001), indicating that resected pairs tended to have higher MI, but this overlap did not distinguish seizure outcomes in this sample. Power was low: a difference of about 0.27 AUC units was needed for 80% power at alpha 0.025. Results are limited by clinical labels, a 90 s epoch, and the small sample; a moderate effect cannot be excluded.

stereoelectroencephalography · SEEG · epilepsy surgery · seizure outcome · NREM sleep · high-frequency activity · phase-amplitude coupling · resection · OpenNeuro