Graph-Based Approaches to Learning Epileptogenic Zone Localization Using Stereo-EEG Recordings

Abstract

The epileptogenic zone (EZ) is the brain region that generates seizures in an individual, and is the target of epilepsy surgery. Localizing the EZ from stereo-EEG (sEEG) recordings supports surgical planning, but manual interpretation is time-consuming and focuses on seizure recordings. Graphical learning models of resting-state functional connectivity among the recorded brain regions are an attractive alternative, but depend crucially on the network topology chosen for the model. We present a controlled study of graph-based models to explore how graph topology affects EZ localization from resting-state sEEG in 40 patients. Using the same simple learnable model and leave-one-patient-out evaluation, we compare dense graphs, anatomy- and geometry-informed priors, budgeted sparsification methods, and learned sparsification, including the proposed Region-Bridge-$c$ topology. To compare graph constructions fairly, we control the number of incoming edges per node and vary graph sparsity. At $\approx 30\%$ edge retention, Region-Bridge-$c$ achieves the highest observed mean PR-AUC ($0.371\pm0.015$; ROC-AUC $0.743\pm0.010$) while using $\approx 69\%$ fewer edges than Dense (PR-AUC $0.349\pm0.014$). Spatial-$k$ is competitive, whereas random pruning requires near-dense retention. Learned sparsification benefits from anatomical node metadata but, on average, does not surpass the best fixed prior. Across all topologies, the best choice varies by patient. These results suggest that graph construction should be evaluated explicitly rather than treated as fixed preprocessing.