Temporal stability of intracranial electroencephalographic abnormality maps for localizing epileptogenic tissue

Objective: Identifying abnormalities on interictal intracranial electroencephalo-gram (iEEG), by comparing patient data to a normative map, has shown promise for the localization of epileptogenic tissue and prediction of outcome. The ap-proach typically uses short interictal segments of approximately 1 min. However, the temporal stability of findings has not been established. Methods: Here, we generated a normative map of iEEG in nonpathological brain tissue from 249 patients. We computed regional band power abnormalities in a separate cohort of 39 patients for the duration of their monitoring period (.92- 8.62 days of iEEG data, mean = 4.58 days per patient, >4800 hours recording). To assess the localizing value of band power abnormality, we computed DRS-a measure of how different the surgically resected and spared tissue was in terms of band power abnormalities- over time. Results: In each patient, the DRS value was relatively consistent over time. The median DRS of the entire recording period separated seizure- free (International League Against Epilepsy [ILAE] = 1) and not-seizure- free (ILAE > 1) patients well (area under the curve [AUC] = .69). This effect was similar interictally (AUC = .69) and peri-ictally (AUC = .71).Significance: Our results suggest that band power abnormality D_RS, as a pre-dictor of outcomes from epilepsy surgery, is a relatively robust metric over time. These findings add further support for abnormality mapping of neurophysiology data during presurgical evaluation.