Epileptogenic Zone Localization: Integrating the Multimodal Scene with Electro-Clinical Information
Approximately one-third of patients with epilepsy present with a drug-resistant form, for which surgery targeting the presumed epileptogenic focus represents a key therapeutic option. However, accurately identifying the Epileptogenic Zone (EZ) remains a complex challenge: traditional neuroimaging and Video-EEG monitoring alone allow only half of the evaluated patients to undergo surgery, with about two-thirds achieving complete seizure freedom. Electrical Source Imaging (ESI) makes it possible to estimate the cortical and subcortical sources of epileptiform activity, but its clinical implementation is limited by analytical complexity and heavy operator dependence.
ESI4EPISURG is a single-center, observational (retrospective and prospective) study designed to develop an automated ESI pipeline and a semi-automated procedure for identifying interictal epileptiform discharges (IEDs) using scalp EEG recordings (at least 32 channels) and structural T1 MRI scans. In compliant prospective patients, electrode positions will be mapped in a patient-specific manner using 3D scanning of the EEG cap. The localization outcomes generated by the ESI pipeline will be compared against conventional multimodal clinical evaluations (Video-EEG, MRI, PET, neuropsychological testing), the surgical resection cavity, and post-operative seizure outcomes to assess accuracy and feasibility.
Aim: implement and validate an automated and accessible ESI pipeline to enhance precision in localizing the Epileptogenic Zone and streamline the presurgical evaluation process in patients with drug-resistant focal epilepsy.
- Promoter: Department of Biomedical, Metabolic, and Neural Sciences – UNIMORE
- Duration: 2026–2031
- Principal Investigator: Prof. Anna Elisabetta Vaudano
- Clinical Site: Neurophysiology Unit and Epilepsy Center, AOU di Modena