Ictal high-frequency power identified clinical SOZ channels in the first seizure, but its advantage did not replicate

In 35 HUP SEEG patients from OpenNeuro ds004100, a 0–10 s ictal increase in 20–150 Hz power identified clinically marked seizure-onset channels in the first seizure (mean within-patient AUC 0.813, 95% CI 0.762–0.861) and outperformed pre-ictal and interictal power. In the second seizure, its AUC was 0.657 (95% CI 0.554–0.755), and the advantage did not replicate. Across two seizures, it was not reliably better than interictal power. Per-patient AUC agreement between seizures was modest (r = 0.44), compared with pre-ictal broadband power (r = 0.81). No tested marker differed by Engel outcome (all p ≥ 0.096), and point estimates did not show greater treated-contact overlap in seizure-free patients. The clinical SOZ was defined by visual reading of ictal onset, making this comparison partly circular. Clinical onset timing, seizure type, one-center sampling, bipolar labeling, and small outcome groups limit interpretation. The analyzed windows were fetched from the live OpenNeuro S3 mirror; the saved source records do not establish an exact immutable dataset release.

SEEG · epilepsy · seizure onset zone · high-frequency power · intracranial EEG · AUC · reproducibility · OpenNeuro ds004100