Seizure localization using three-dimensional surface projections of intracranial EEG power

Hyang Woon Lee, Mark W. Youngblood, Pue Farooque, Xiao Han, Stephen Jhun, William C. Chen, Irina Goncharova, Kenneth Vives, Dennis D. Spencer, Hitten Zaveri, Lawrence J. Hirsch, Hal Blumenfeld

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Intracranial EEG (icEEG) provides a critical road map for epilepsy surgery but it has become increasingly difficult to interpret as technology has allowed the number of icEEG channels to grow. Borrowing methods from neuroimaging, we aimed to simplify data analysis and increase consistency between reviewers by using 3D surface projections of intracranial EEG poweR (3D-SPIER). We analyzed 139 seizures from 48 intractable epilepsy patients (28 temporal and 20 extratemporal) who had icEEG recordings, epilepsy surgery, and at least one year of post-surgical follow-up. We coregistered and plotted icEEG β frequency band signal power over time onto MRI-based surface renderings for each patient, to create color 3D-SPIER movies. Two independent reviewers interpreted the icEEG data using visual analysis vs. 3D-SPIER, blinded to any clinical information. Overall agreement rates between 3D-SPIER and icEEG visual analysis or surgery were about 90% for side of seizure onset, 80% for lobe, and just under 80% for sublobar localization. These agreement rates were improved when flexible thresholds or frequency ranges were allowed for 3D-SPIER, especially for sublobar localization. Interestingly, agreement was better for patients with good surgical outcome than for patients with poor outcome. Localization using 3D-SPIER was measurably faster and considered qualitatively easier to interpret than visual analysis. These findings suggest that 3D-SPIER could be an improved diagnostic method for presurgical seizure localization in patients with intractable epilepsy and may also be useful for mapping normal brain function.

Original languageEnglish
Pages (from-to)616-626
Number of pages11
StatePublished - Dec 2013

Bibliographical note

Funding Information:
This work was supported by the Ewha Global Top 5 Grant 2011 of Ewha Womans University and the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology [ R01-2011-0015788 to HWL], by the National Institutes of Health [ R01 NS055829 to HB], and by the Betsy and Jonathan Blattmachr Family .


  • Brain mapping
  • Electrocorticography (ECoG)
  • Epilepsy
  • Outcome
  • Surgery


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