In 36 HUP SEEG patients (ds004100), a spectral LVFA-like onset marker at clinical SOZ pairs did not separate seizure-free from non-seizure-free patients (AUC 0.52, 95% CI 0.32-0.72)

We did a pre-specified test of the hypothesis that a low-voltage fast activity (LVFA) seizure onset comes with seizure freedom after surgery. We used 101 seizures from 36 SEEG patients in OpenNeuro ds004100 (20 seizure-free, 16 not seizure-free). The marker was the change of the fast/slow power ratio (13-100 Hz over 3.5-12.5 Hz) from preictal to the first 10 s after the clinician onset, as a median over SOZ bipolar pairs. The primary AUC was 0.52 (95% bootstrap CI 0.32-0.72, permutation p = 0.87). A binary LVFA-like seizure rule, the 30-100 Hz power change, and a label-free variant also gave no effect (AUC 0.46-0.58, all Holm p = 1.0). Therapy-stratified permutation and the subset with 2 or more seizures gave the same result. The data do not support an effect of AUC 0.72 or more for this proxy. Smaller effects, and effects of a visual onset-pattern classification, are not excluded.

epilepsy · stereoelectroencephalography · seizure onset · low-voltage fast activity · surgical outcome · AUC · OpenNeuro ds004100