Emerging personalized virtual brain models: next-generation resection neurosurgery for drug-resistant epilepsy?

Abstract

Abstract Recently, a novel workflow known as the virtual epileptic patient (VEP) has been proposed by a research team from Aix Marseille Université in their papers published in Lancet Neurology, Science Translational Medicine and Epilepsia. This method involves creating an individualized virtual brain model based on computational modelling, which can facilitate clinical decision-making by estimating the epileptogenic zone and performing the virtual surgery. Here, we summarize brief workflow, strengths, and limitations of VEP, as well as its performance in a retrospective study of 53 patients with drug-resistant focal epilepsy who underwent stereoelectroencephalography. A large-scale clinical trial (NCT03643016) is underway to further assess VEP, which is expected to enroll 356 patients prospectively. As supporting evidence accumulates, the clinical application of VEP has the potential to improve clinical practice, leading to better outcomes and qualities of life of patients.

Keywords

• Drug-resistant focal epilepsy
• Personalized virtual brain models
• Machine learning
• Epileptogenic zone networks
• Stereoelectroencephalography
• Virtual surgery