Optimization of patient-specific stereo-EEG recording sensitivity

Abstract Stereo-EEG is a minimally invasive technique used to localize the origin of epileptic activity (the epileptogenic zone) in patients with drug-resistant epilepsy. However, current stereo-EEG trajectory planning methods are agnostic to the spatial recording sensitivity of the implanted electrodes. We used image-based patient-specific computational models to design optimized stereo-EEG electrode configurations. Patient-specific optimized electrode configurations exhibited substantially higher recording sensitivity than clinically implanted configurations, and this may lead to more accurate delineation of the epileptogenic zone. The optimized configurations also achieved as good as or better recording sensitivity with fewer electrodes compared to clinically implanted configurations, and this may reduce the risk for complications including intracranial hemorrhage. This approach improves localization of the epileptogenic zone by transforming the clinical use of stereo-EEG from a discrete ad hoc sampling to an intelligent mapping of the regions of interest.