By Viktor Jirsa
Patient-specific brain network modeling allows discovery of novel treatment procedures
Since the development of epilepsy surgery as a treatment modality for patients with medically refractory focal epilepsy (MRE), the achievement of seizure freedom has been shown to be strongly correlated with the identification and the complete removal of the epileptogenic zone (EZ). The current approach is to try to formulate an epilepsy “pace maker” localization hypothesis based on at times (1) falsely localizing surface EEG patterns or on (2) large network-generated semiological signs. As a consequence, surgical resections may lead to high incidence of failures or patients (30-40%). Virtual Brain Technology represents a novel method exploring focal epilepsies based on mapping of the various nodes of brain networks (using SEEG and computer-based simulation paradigms) that drive the development of the electrophysiological (EEG) and clinical (semiological) expression of MRI-negative focal epilepsies, identifying the generator(s) (EZ), and creating stereotactically guided focal lesions in critical nodes within the mapped networks. This novel approach allows the discovery and systematic evaluation of novel interventions outside of the established clinical surgery.