Early Detection of Human Epileptic Seizures Based on Intracortical Microelectrode Array Signals.

OBJECTIVE: We examine, for the first time, the use of intracortical microelectrode array (MEA) signals for early detection of human epileptic seizures. METHODS: 4×4 mm2 96-channel-MEA recordings were obtained during neuro-monitoring preceding resective surgery in five participants. The participant-specific seizure-detection framework consisted of: first, feature extraction from local field potentials (LFPs) and multiunit activity (MUA); second, nonlinear cost-sensitive support vector machine (SVM) classification of ictal and interictal states based on LFP, MUA, and combined LFP-MUA (a SVM was trained for each participant separately); and third, Kalman filter postprocessing of SVM scoring functions. Performance was assessed on data including 17 seizures and 39.0 h interictal and preictal recordings. RESULTS: The use of combined LFP-MUA features resulted in 100% sensitivity with short detection latency (average: 2.7 s; median: 2.5 s) and five false alarms (0.13/h). The average detection performance based on the area under the receiver operating characteristic corresponded to 0.97. Importantly, technically false alarms were related to epileptiform activity, subclinical seizures, and recording artifacts. Extreme gradient boosting classifiers ranked features based on LFP spectral coherence or MUA count among the top features for seizures characterized by spike-wave complexes, whereas features related to LFP power spectra were ranked higher for seizures characterized by sustained gamma LFP oscillations. CONCLUSION: The combination of intracortical LFP and MUA signals may allow reliable detection of human epileptic seizures by improving latency and false alarm rate. SIGNIFICANCE: Intracortical MEAs provide promising signals for closed-loop seizure-control systems based on seizure early-detection in people with pharmacologically resistant epilepsies.

Intracortical neural activity distal to seizure-onset-areas predicts human focal seizures.

The apparent unpredictability of epileptic seizures has a major impact in the quality of life of people with pharmacologically resistant seizures. Here, we present initial results and a proof-of-concept of how focal seizures can be predicted early in advance based on intracortical signals recorded from small neocortical patches away from identified seizure onset areas. We show that machine learning algorithms can discriminate between interictal and preictal periods based on multiunit activity (i.e. thresholded action potential counts) and multi-frequency band local field potentials recorded via 4 X 4 mm2 microelectrode arrays. Microelectrode arrays were implanted in 5 patients undergoing neuromonitoring for resective surgery. Post-implant analysis revealed arrays were outside the seizure onset areas. Preictal periods were defined as the 1-hour period leading to a seizure. A 5-minute gap between the preictal period and the putative seizure onset was enforced to account for potential errors in the determination of actual seizure onset times. We used extreme gradient boosting and long short-term memory networks for prediction. Prediction accuracy based on the area under the receiver operating characteristic curves reached 90% for at least one feature type in each patient. Importantly, successful prediction could be achieved based exclusively on multiunit activity. This result indicates that preictal activity in the recorded neocortical patches involved not only subthreshold postsynaptic potentials, perhaps driven by the distal seizure onset areas, but also neuronal spiking in distal recurrent neocortical networks. Beyond the commonly identified seizure onset areas, our findings point to the engagement of large-scale neuronal networks in the neural dynamics building up toward a seizure. Our initial results obtained on currently available human intracortical microelectrode array recordings warrant new studies on larger datasets, and open new perspectives for seizure prediction and control by emphasizing the contribution of multiscale neural signals in large-scale neuronal networks.

A modular, closed-loop platform for intracranial stimulation in people with neurological disorders.

Neuromodulation systems based on electrical stimulation can be used to investigate, probe, and potentially treat a range of neurological disorders. The effects of ongoing neural state and dynamics on stimulation response, and of stimulation parameters on neural state, have broad implications for the development of closed-loop neuro-modulation approaches. We describe the development of a modular, low-latency platform for pre-clinical, closed-loop neuromodulation studies with human participants. We illustrate the uses of the platform in a stimulation case study with a person with epilepsy undergoing neuro-monitoring prior to resective surgery. We demonstrate the efficacy of the system by tracking interictal epileptiform discharges in the local field potential to trigger intracranial electrical stimulation, and show that the response to stimulation depends on the neural state.