Virtual brain twins for stimulation in epilepsy

Estimating the epileptogenic zone network (EZN) is an important part of the diagnosis of drug-resistant focal epilepsy and has a pivotal role in treatment and intervention. Virtual brain twins provide a modeling method for personalized diagnosis and treatment. They integrate patient-specific brain topography with structural connectivity from anatomical neuroimaging such as magnetic resonance imaging, and dynamic activity from functional recordings such as electroencephalography (EEG) and stereo-EEG (SEEG). Seizures show rich spatial and temporal features in functional recordings, which can be exploited to estimate the EZN. Stimulation-induced seizures can provide important and complementary information. Here we consider invasive SEEG stimulation and non-invasive temporal interference stimulation as a complementary approach. This paper offers a high-resolution virtual brain twin framework for EZN diagnosis based on stimulation-induced seizures. It provides an important methodological and conceptual basis to make the transition from invasive to non-invasive diagnosis and treatment of drug-resistant focal epilepsy.