A Computational Biomarker of Photosensitive Epilepsy from Interictal EEG

People with photosensitive epilepsy (PSE) are prone to seizures elicited by visual stimuli. The possibility of inducing epileptiform activity in a reliable way makes PSE a useful model to understand epilepsy, with potential applications for the development of new diagnostic methods and new treatments for epilepsy. A relationship has been demonstrated between PSE and both occipital and more widespread cortical hyperexcitability using various types of stimulation. Here we aimed to test whether hyperexcitability could be inferred from resting interictal electroencephalographic (EEG) data without stimulation. We considered a cohort of 46 individuals with idiopathic generalized epilepsy who underwent EEG during intermittent photic stimulation: 26 had a photoparoxysmal response (PPR), the PPR group, and 20 did not, the non-PPR group. For each individual, we computed functional networks from the resting EEG data before stimulation. We then placed a computer model of ictogenicity into the networks and simulated the propensity of the network to generate seizures in silico [the brain network ictogenicity (BNI)]. Furthermore, we computed the node ictogenicity (NI), a measure of how much each brain region contributes to the overall ictogenic propensity. We used the BNI and NI as proxies for testing widespread and occipital hyperexcitability, respectively. We found that the BNI was not higher in the PPR group relative to the non-PPR group. However, we observed that the (right) occipital NI was significantly higher in the PPR group relative to the non-PPR group. Other regions did not have significant differences in NI values between groups.