Predicting seizure onset zones from interictal intracranial EEG using functional connectivity and machine learning

Sci Rep. 2025 May 22;15(1):17801. doi: 10.1038/s41598-025-02679-4.

Abstract

Functional connectivity (FC) analyses of intracranial EEG (iEEG) signals can potentially improve the mapping of epileptic networks in drug-resistant focal epilepsy. However, it remains unclear whether FC-based metrics provide additional value beyond established epilepsy biomarkers such as epileptic spikes and high-frequency oscillations (HFOs). Using interictal iEEG data from 26 patients, we estimated FC across eight frequency bands (4-290 Hz) using amplitude envelope correlation (AEC) and phase locking value (PLV). From the resulting FC-matrices, we estimated two graph metrics each to derive 32 FC-based features. We also extracted features related to spikes, HFOs, and power spectral densities (PSD). A trained support vector machine (SVM) classifier predicted seizure onset zones (SOZs) with an area under the ROC curve (AUC) of 0.91 for node-level 4-fold cross-validation (CV), 0.69 for patient-level 4-fold CV, and 0.73 for patient-level leave-one-out CV. Notably, gamma-band graph features from AECs outperformed spikes and HFOs in SOZ prediction when using an equivalent number of features. Our results strongly suggest that AEC-based features may provide more information about epileptogenicity compared to PLV-based features. Furthermore, machine learning provides a robust approach for identifying useful FC-based features and integrating information from putative biomarkers of epilepsy to better localize epileptogenic networks.

Keywords: Biomarkers; Epileptogenicity; Functional connectivity; Intracranial EEG; Machine learning; Seizure onset zone.

MeSH terms

  • Adolescent
  • Adult
  • Drug Resistant Epilepsy / physiopathology
  • Electrocorticography* / methods
  • Electroencephalography* / methods
  • Female
  • Humans
  • Machine Learning*
  • Male
  • Middle Aged
  • ROC Curve
  • Seizures* / diagnosis
  • Seizures* / physiopathology
  • Support Vector Machine
  • Young Adult