Ictal SEEG markers aligned with clinical seizure-onset channels but did not outperform interictal power or predict outcome

In 36 patients with SEEG from OpenNeuro ds004100 v1.1.3, ictal markers separated clinically labelled seizure-onset-zone (SOZ) channels from other bipolar channels in two recorded seizures. Across five markers, run-01 mean AUCs ranged from 0.680 to 0.811 (n=35); run-02 values ranged from 0.666 to 0.735 (n=33), with Holm-corrected p < 0.004 in both runs. Ictal EI AUC did not differ from interictal log-delta-power AUC (run-01 difference -0.004, 95% CI -0.08 to 0.07, p=0.91; run-02 +0.022, p=0.64), and patient-level AUCs were not correlated. No association was found between seizure outcome and the treated share of high-EI channels or EI discrimination of treated from untreated channels. Line-length ratio exceeded EI in run-01 but not run-02. Between-seizure marker rank agreement was moderate (median Spearman rho 0.42-0.51). Clinical SOZ labels partly derive from the same seizures, so these AUCs measure agreement with clinical labels, not true localization. The study used short windows, one center, one or two seizures per patient, and small outcome groups; ablation and resection were pooled.

stereo-EEG · seizure-onset zone · epileptogenicity index · intracranial EEG · epilepsy · AUC · surgical outcome