Connectivity of high-frequency bursts as SOZ localization biomarker.

For patients with refractory epilepsy, the seizure onset zone (SOZ) plays an essential role in determining the specific regions of the brain that will be surgically resected. High-frequency oscillations (HFOs) and connectivity-based approaches have been identified among the potential biomarkers to localize the SOZ. However, there is no consensus on how connectivity between HFO events should be estimated, nor on its subject-specific short-term reliability. Therefore, we propose the channel-level connectivity dispersion (CLCD) as a metric to quantify the variability in synchronization between individual electrodes and to identify clusters of electrodes with abnormal synchronization, which we hypothesize to be associated with the SOZ. In addition, we developed a specialized filtering method that reduces oscillatory components caused by filtering broadband artifacts, such as sharp transients, spikes, or direct current shifts. Our connectivity estimates are therefore robust to the presence of these waveforms. To calculate our metric, we start by creating binary signals indicating the presence of high-frequency bursts in each channel, from which we calculate the pairwise connectivity between channels. Then, the CLCD is calculated by combining the connectivity matrices and measuring the variability in each electrodes combined connectivity values. We test our method using two independent open-access datasets comprising intracranial electroencephalography signals from 89 to 15 patients with refractory epilepsy, respectively. Recordings in these datasets were sampled at approximately 1000Hz, and our proposed CLCDs were estimated in the ripple band (80-200Hz). Across all patients in the first dataset, the average ROC-AUC was 0.73, and the average Cohens d was 1.05, while in the second dataset, the average ROC-AUC was 0.78 and Cohens d was 1.07. On average, SOZ channels had lower CLCD values than non-SOZ channels. Furthermore, based on the second dataset, which includes surgical outcomes (Engel I-IV), our analysis suggested ...