Desynchronization Index: a New Approach for Exploring Complex Epileptogenic Networks in Stereoelectroencephalography

Stereoelectroencephalography (SEEG) is an invasive surgical procedure to record the electrical activities in cortical brain regions, aiming at identifying the Epileptogenic Zone (EZ) in patients with drug-resistant epilepsy. To improve the accuracy of the EZ definition, SEEG analysis can be supported by computational tools, among which the Epileptogenic Index (EI) represents the most common solution. However, the scientific community has still not found an agreement on which quantitative biomarkers can characterize the cortical sites within the EZ. In this work, we design a new algorithm, named Desynchronization Index (DI), to assist neurophysiologists in SEEG interpretation. Our algorithm estimates the effective connectivity between cortical sites and hypothesizes that the EZ is identified by those sites getting abnormally desynchronized from the network during the seizure generation. We test the proposed method over a SEEG dataset of 10 seizures, comparing its accuracy in terms of EZ definition against the EI algorithm and clinical ground truth. Our results indicate that the DI algorithm underscores specific connectivity dynamics that can hardly be identified with a pure visual analysis, increasing sensitivity in detecting epileptogenic cortical sites.