title: Individual brain structure and modelling predict seizure propagation.
abstract: See Lytton (doi:10.1093/awx018) for a scientific commentary on this article.Neural network oscillations are a fundamental mechanism for cognition, perception and consciousness. Consequently, perturbations of network activity play an important role in the pathophysiology of brain disorders. When structural information from non-invasive brain imaging is merged with mathematical modelling, then generative brain network models constitute personalized in silico platforms for the exploration of causal mechanisms of brain function and clinical hypothesis testing. We here demonstrate with the example of drug-resistant epilepsy that patient-specific virtual brain models derived from diffusion magnetic resonance imaging have sufficient predictive power to improve diagnosis and surgery outcome. In partial epilepsy, seizures originate in a local network, the so-called epileptogenic zone, before recruiting other close or distant brain regions. We create personalized large-scale brain networks for 15 patients and simulate the individual seizure propagation patterns. Model validation is performed against the presurgical stereotactic electroencephalography data and the standard-of-care clinical evaluation. We demonstrate that the individual brain models account for the patient seizure propagation patterns, explain the variability in postsurgical success, but do not reliably augment with the use of patient-specific connectivity. Our results show that connectome-based brain network models have the capacity to explain changes in the organization of brain activity as observed in some brain disorders, thus opening up avenues towards discovery of novel clinical interventions.
authors.affiliation: Aix Marseille Univ, Inserm, INS, Institut de Neurosciences des Systèmes, Marseille, France.
authors.forename: Timothée
authors.initials: T
authors.lastname: Proix
authors.affiliation: Aix Marseille Univ, Inserm, INS, Institut de Neurosciences des Systèmes, Marseille, France.|Assistance Publique - Hôpitaux de Marseille, Hôpital de la Timone, Service de Neurophysiologie Clinique, CHU, 13005 Marseille, France.
authors.forename: Fabrice
authors.initials: F
authors.lastname: Bartolomei
authors.affiliation: Aix-Marseille Université, Centre de Résonance Magnétique et Biologique et Médicale (CRMBM, UMR CNRS-AMU 7339), Medical School of Marseille, 13005, Marseille, France.|Assistance Publique - Hôpitaux de Marseille, Hôpital de la Timone, CEMEREM, Pôle d'Imagerie Médicale, CHU, 13005, Marseille, France.
authors.forename: Maxime
authors.initials: M
authors.lastname: Guye
authors.affiliation: Aix Marseille Univ, Inserm, INS, Institut de Neurosciences des Systèmes, Marseille, France.
authors.forename: Viktor K
authors.initials: VK
authors.lastname: Jirsa
mesh_terms: D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology*; D001931:Brain Mapping; D004569:Electroencephalography; D004828:Epilepsies, Partial / Q000175:diagnosis* / Q000473:pathology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D008959:Models, Neurological; D009434:Neural Pathways / Q000473:pathology; D011237:Predictive Value of Tests; D055815:Young Adult
keywords: brain network models; connectomes; epilepsy; individualized medicine; seizure propagation