Virtual brain twins: from basic neuroscience to clinical use.

Virtual brain twins are personalized, generative and adaptive brain models based on data from an individual's brain for scientific and clinical use. After a description of the key elements of virtual brain twins, we present the standard model for personalized whole-brain network models. The personalization is accomplished using a subject's brain imaging data by three means: (1) assemble cortical and subcortical areas in the subject-specific brain space; (2) directly map connectivity into the brain models, which can be generalized to other parameters; and (3) estimate relevant parameters through model inversion, typically using probabilistic machine learning. We present the use of personalized whole-brain network models in healthy ageing and five clinical diseases: epilepsy, Alzheimer's disease, multiple sclerosis, Parkinson's disease and psychiatric disorders. Specifically, we introduce spatial masks for relevant parameters and demonstrate their use based on the physiological and pathophysiological hypotheses. Finally, we pinpoint the key challenges and future directions.

From phenomenological to biophysical models of seizures.

Epilepsy is a complex disease that requires various approaches for its study. This short review discusses the contribution of theoretical and computational models. The review presents theoretical frameworks that underlie the understanding of certain seizure properties and their classification based on their dynamical properties at the onset and offset of seizures. Dynamical system tools are valuable resources in the study of seizures. These tools can provide insights into seizure mechanisms and offer a framework for their classification, by analyzing the complex, dynamic behavior of seizures. Additionally, computational models have high potential for clinical applications, as they can be used to develop more accurate diagnostic and personalized medicine tools. We discuss various modeling approaches that span different scales and levels, while also questioning the neurocentric view, emphasizing the importance of considering glial cells. Finally, we explore the epistemic value provided by this type of approach.

Delineating epileptogenic networks using brain imaging data and personalized modeling in drug-resistant epilepsy.

Precise estimates of epileptogenic zone networks (EZNs) are crucial for planning intervention strategies to treat drug-resistant focal epilepsy. Here, we present the virtual epileptic patient (VEP), a workflow that uses personalized brain models and machine learning methods to estimate EZNs and to aid surgical strategies. The structural scaffold of the patient-specific whole-brain network model is constructed from anatomical T1 and diffusion-weighted magnetic resonance imaging. Each network node is equipped with a mathematical dynamical model to simulate seizure activity. Bayesian inference methods sample and optimize key parameters of the personalized model using functional stereoelectroencephalography recordings of patients' seizures. These key parameters together with their personalized model determine a given patient's EZN. Personalized models were further used to predict the outcome of surgical intervention using virtual surgeries. We evaluated the VEP workflow retrospectively using 53 patients with drug-resistant focal epilepsy. VEPs reproduced the clinically defined EZNs with a precision of 0.6, where the physical distance between epileptogenic regions identified by VEP and the clinically defined EZNs was small. Compared with the resected brain regions of 25 patients who underwent surgery, VEP showed lower false discovery rates in seizure-free patients (mean, 0.028) than in non-seizure-free patients (mean, 0.407). VEP is now being evaluated in an ongoing clinical trial (EPINOV) with an expected 356 prospective patients with epilepsy.

VEP atlas: An anatomic and functional human brain atlas dedicated to epilepsy patients.

BACKGROUND: Several automated parcellation atlases of the human brain have been developed over the past decades, based on various criteria, and have been applied in basic and clinical research. NEW METHOD: Here we present the Virtual Epileptic Patient (VEP) atlas that offers a new automated brain region parcellation and labeling, which has been developed for the specific use in the domains of epileptology and functional neurosurgery and is able to apply at individual patient's level. RESULTS: It comprises 162 brain regions, including 73 cortical and 8 subcortical regions per hemisphere. We demonstrate the successful application of the VEP atlas in a cohort of 50 retrospective patients. The structural organization is complemented by the functional variation of stereotactic intracerebral EEG (SEEG) signal data features establishing brain region-specific 3d-maps. COMPARISON WITH EXISTING METHODS: The VEP atlas integrates both anatomical and functional definitions in the same atlas, adapted to applications for epilepsy patients and individualizable. CONCLUSION: The covariation of structural and functional organization is the basis for current efforts of patient-specific large-scale brain network modeling exploiting virtual brain technologies for the identification of the epileptogenic regions in an ongoing prospective clinical trial EPINOV.

MULAN: Evaluation and ensemble statistical inference for functional connectivity.

Many analysis methods exist to extract graphs of functional connectivity from neuronal networks. Confidence in the results is limited because, (i) different methods give different results, (ii) parameter setting directly influences the final result, and (iii) systematic evaluation of the results is not always performed. Here, we introduce MULAN (MULtiple method ANalysis), which assumes an ensemble based approach combining multiple analysis methods and fuzzy logic to extract graphs with the most probable structure. In order to reduce the dependency on parameter settings, we determine the best set of parameters using a genetic algorithm on simulated datasets, whose temporal structure is similar to the experimental one. After a validation step, the selected set of parameters is used to analyze experimental data. The final step cross-validates experimental subsets of data and provides a direct estimate of the most likely graph and our confidence in the proposed connectivity. A systematic evaluation validates our strategy against empirical stereotactic electroencephalography (SEEG) and functional magnetic resonance imaging (fMRI) data.

A systematic framework for functional connectivity measures.

Various methods have been proposed to characterize the functional connectivity between nodes in a network measured with different modalities (electrophysiology, functional magnetic resonance imaging etc.). Since different measures of functional connectivity yield different results for the same dataset, it is important to assess when and how they can be used. In this work, we provide a systematic framework for evaluating the performance of a large range of functional connectivity measures-based upon a comprehensive portfolio of models generating measurable responses. Specifically, we benchmarked 42 methods using 10,000 simulated datasets from 5 different types of generative models with different connectivity structures. Since all functional connectivity methods require the setting of some parameters (window size and number, model order etc.), we first optimized these parameters using performance criteria based upon (threshold free) ROC analysis. We then evaluated the performance of the methods on data simulated with different types of models. Finally, we assessed the performance of the methods against different levels of signal-to-noise ratios and network configurations. A MATLAB toolbox is provided to perform such analyses using other methods and simulated datasets.