SEEG Time-Frequency Fingerprint Analysis for Epileptogenic Zone Localization (under construction)

Authors: xxx.

This tutorial introduces some concepts that are specific to the management of intracranial, SEEG recordings in the Brainstorm environment, and explains how to compute maps of epileptogenicity from ictal and interictal recordings. It is based on a clinical case from the McGovern Medical School, University of Texas Health Science Center at Houston, Texas, USA.

Note that the operations used here are not detailed, the goal of this tutorial is not to introduce Brainstorm to new users. For in-depth explanations of the interface and theoretical foundations, please refer to the introduction tutorials.

NOT FOR CLINICAL USE:
The performance characteristics of the methods and software implementation presented in this tutorial have not been certified as medical devices and should be used for research purposes only.

Dataset description

License

This tutorial dataset (EEG, MRI and CT data) remains property of the McGovern Medical School, University of Texas Health Science Center at Houston, Texas, USA. Its use and transfer outside the Brainstorm tutorials, e.g. for research purposes, is prohibited without written consent. For questions, please contact Yash Shashank Vakilna, MS ( Yash.Shashank.Vakilna@uth.tmc.edu ).

Clinical description

The dataset was recorded at the Epilepsy Monitoring Unit at UTHealth Houston. It includes recordings for a patient who was a 25-year-old right-handed woman with drug-resistant epilepsy since age six and a prior right parietal opercular corticectomy at 15 presented with weekly focal aware seizures featuring a left-hand tingling aura and focal impaired awareness seizures with staring and pouting. In the Epilepsy Monitoring Unit (EMU) she had intermittent right parietal slowing and ten habitual seizures arising from C4-P4, and MRI revealed bilateral perisylvian polymicrogyria (PMG), pachygyria, right posterior temporal periventricular nodular heterotopia, and post-surgical changes. MEG localized discharges to the right superior parietal region adjacent to her previous resection, and SEEG implantation mapped two distinct onset patterns: low-voltage fast activity in right superior parietal PMG during focal aware seizures and repetitive spiking in posterior insular PMG during impaired awareness seizures. After multidisciplinary review, she underwent uncomplicated MR-guided laser interstitial thermal therapy targeting the right superior parietal and posterior insular PMG and remained seizure-free at one-year follow-up.

SEEG recordings

https://neuroimage.usc.edu/brainstorm/Tutorials/IeegContactLocalization?action=AttachFile&do=get&target=pmt.png

The depth electrodes used in this example dataset are PMT SEEG Depth Electrodes, with the following specifications:

Files

tutorial_seizure_fingerprinting/

References

All details for this study can be found here: https://zenodo.org/records/14807262

Download and installation

Import the anatomy

Pre-implantation MRI

While it is not applicable to this data, but while importing some MRIs if there is a transformation available in the NIfTI header, then a window pops up asking Do you would want to apply the transformation to the MRI file ? Choosing Yes will orient the MRI based on this transformation and will reorient the MRI in Brainstorm's standard orientation, so you can see the coronal/sagittal/axial views correctly oriented. More details.

Post-implantation CT

The pre-implantation MRI above will be used as the anatomical reference for this subject. We will now import a second scan done after the SEEG implantation, on which we can see the SEEG contacts. In this dataset, the post-implantation volume is a CT scan (contacts hypersignal appear in white).

Generate default surfaces using CAT12

We recommend generating cortical surfaces with CAT12, especially if you are interested in a realistic representation of the patient's cortical folding in 3D. Follow the CAT12 tutorial to generate the surfaces as under.

14_seg_cat12.png

These surfaces will be used later, in the computation of the epileptogenicity maps. Read the section Importing realistic surfaces for information on how to use realistic surfaces from BrainVISA or FreeSurfer.

Electrode labeling and contact localization

If you do not have any recordings in the database, Brainstorm allows to creation and annotation of intracranial electrodes and contacts. Users can also then export these as a text file with all the positions that can be used in Brainstorm or any other program.

Generate isoSurface

This creates a thresholded mesh from the CT by separating the contacts out from rest of the CT. This aids the user towards localization of the electrodes and its contacts more accurately.

Start implantation

To know more about the panel and its features go to Panel iEEG.

Create electrodes and plot contacts manually

In some cases, additional correction of the contacts may be required. To edit the individual contacts refer to the Edit the contacts positions section below.

Export the contacts position

Access the recordings

Import the contacts positions

In order to generate epileptogenicity maps, we need accurate 3D positions for the contacts of the depth electrodes. Placing the contacts requires a good understanding of the implantation scheme reported by the neurosurgeon, and some skills in reading MRI scans. To make this tutorial easier to reproduce and follow, we distribute the positions of the contacts (that were localized as per the section above) saved in a .tsv file.

Display the depth electrodes

3D figures

MRI Viewer

Panel iEEG

Display SEEG recordings

To know more about ways to display the SEEG recordings in Brainstorm refer to the Epileptogenicity tutorial.

Review recordings

Power spectrum

We recommend you always start your data analysis with a spectral evaluation of the recordings. This is described in more details in the tutorials Power spectrum, EEG and epilepsy and Epileptogenicity.

Add annotations

We need to annotate seizure onset event for the ictal and LVFA and wave recordings and spike event for interictal recording. There are events already available in recordings, that were marked for clinical use, to jump quickly to the page of interest. More details can be found in the tutorial Event Markers.

Import epochs of interest

At this point of the analysis, we are still looking at the original files, no SEEG data was copied to the database. The montages are saved in the Brainstorm preferences, the new events are saved in the links of the database.

We are now going to import the three segment of recordings i.e. LVFA and wave , ictal repetitive spike and interictal spike which are a subset of the Baseline recording.

Import in database

Bipolar montage

We will run the rest of the analysis using a bipolar montage (bipolar-2). The montage selected in the Record tab is for visualization only, most processes ignore this selection and work only on the original common-reference data. To force all the processes to work on the bipolar values, we need to explicitly apply the montage to the recordings. More details can be found in tutorials Montage editor and Epileptogenicity.

Head modeling

The forward models depend on the subject's anatomy, including head size and geometry, tissue conductivity, the computational method, and sensor characteristics. In this section, we will use the Boundary Element Method (BEM) approach available in Brainstorm for constructing the head model for sEEG. For more details on head modeling please refer to the tutorial Head modeling. Follow the tutorial Realistic head model: BEM with OpenMEEG to generate BEM head surfaces from the MRI.

Modeling interictal spikes using Min-Norm Imaging

Modeling ictal wave using Min-Norm Imaging

Modeling ictal onset with Low Voltage Fast Activity (LVFA) using fingerprint analysis (Sensor Space)

Modeling ictal onset with LVFA using fingerprint analysis (Source Space)

Modeling ictal onset with repetitive spiking (Sensor and Source Space)

Advanced

SEEG/ECOG Implantation Menu

While starting manual implantation on an volume by right click on subject node > SEEG/ECOG implantation, the menu below pops up allowing the user to choose which modality or modalities to proceed with.

12_implant_menu.png

Advanced

Skull Stripping

Skull stripping is done on the MRI volume to get a binary volumetric mask of just the brain region. On applying this mask to volumes like CT, it helps in removing any non-brain tissues like skull, scalp, fat, and any other head tissues from the CT volume. In this tutorial, we have a CT scan of a subject with intracranial electrodes, so on applying this mask not only removes the non-brain tissues but also the hanging extracranial wires. Brainstorm has the following menu options for skull stripping:

4_coreg_clean_ct.png

Advanced

Edit the contacts positions

The trajectory of electrode while implantation may not always follow a straight line as there could be bending introduced when the neurosurgeon inserts the electrode. In such cases we need to move these contacts to more appropriate positions.

Additional Documentation

Forum discussions

Tutorials/SeizureFingerprinting (last edited 2025-05-13 17:41:26 by ChinmayChinara)