Evidence map›Paper›PMID 41770259›Full record

SynthesisEpilepsia2026

Intracranial electroencephalographic connectivity analysis to localize epileptogenic networks: Systematic review and meta-analysis from ILAE Epilepsy Surgery Networks Task Force.

Nishant Sinha, Daniel J Zhou, Victoria L Morgan, Dario J Englot, Leonardo Bonilha, Milan Brázdil, Xiaosong He, Riki Masumoto, Quy Cao, Terence J O'Brien and 6 more

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Epilepsia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Nishant SinhaDepartment of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.ORCID https://orcid.org/0000-0002-2090-4889
Daniel J ZhouDepartment of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.ORCID https://orcid.org/0000-0002-0154-8348
Victoria L MorganDepartment of Biomedical Engineering, Vanderbilt University Medical Center, Nashville, Tennessee, USA.ORCID https://orcid.org/0000-0001-8263-2324
Dario J EnglotDepartment of Biomedical Engineering, Vanderbilt University Medical Center, Nashville, Tennessee, USA.ORCID https://orcid.org/0000-0001-8373-690X
Leonardo BonilhaDepartment of Neurology, University of South Carolina, Columbia, South Carolina, USA.ORCID https://orcid.org/0000-0002-6153-8942
Milan BrázdilBrno Epilepsy Center, First Department of Neurology, St. Anne's University Hospital and School of Medicine, Masaryk University, Brno, Czech Republic.ORCID https://orcid.org/0000-0001-7979-2343
Xiaosong HeDepartment of Psychology, University of Science and Technology of China, Hefei, China.ORCID https://orcid.org/0000-0002-7941-2918
Riki MasumotoDepartment of Neurology, Kyoto University, Kyoto, Japan.ORCID https://orcid.org/0000-0003-3985-9210
Quy CaoDepartment of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.ORCID https://orcid.org/0000-0002-6204-1305
Terence J O'BrienDepartment of Neuroscience, School of Translational Medicine, Alfred Health, and Monash University, Melbourne, Victoria, Australia.ORCID https://orcid.org/0000-0002-7198-8621
Chengyuan WuDepartment of Neurosurgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.ORCID https://orcid.org/0000-0002-3954-2929
Erik KaestnerDepartments of Radiation Medicine & Applied Sciences and Psychiatry, University of California, San Diego, San Diego, Georgia, USA.ORCID https://orcid.org/0000-0003-3252-5365
Carrie McDonaldDepartments of Radiation Medicine & Applied Sciences and Psychiatry, University of California, San Diego, San Diego, Georgia, USA.ORCID https://orcid.org/0000-0002-0721-5640
Ezequiel GleichgerrchtDepartment of Neurology, Emory University, Atlanta, Georgia, USA.ORCID https://orcid.org/0000-0002-4212-4146
Aileen McGonigalFaculty of Health, Medicine and Behavioural Sciences, University of Queensland, Brisbane, Queensland, Australia.ORCID https://orcid.org/0000-0001-6775-5318
Kathryn A DavisDepartment of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.ORCID https://orcid.org/0000-0002-7020-6480

Funding

Biomarkers to Predict Outcome from Responsive Brain Stimulation for EpilepsyR61NS125568 · NINDS · UNIVERSITY OF PENNSYLVANIA · PI DAVIS, KATHRYN ADAMIAK · 2023 to 2025
$3.6M
Optimized Intracranial EEG Targeting in Focal Epilepsy based upon Neuroimaging ConnectomicsR01NS116504 · NINDS · UNIVERSITY OF PENNSYLVANIA · PI DAVIS, KATHRYN ADAMIAK · 2021 to 2025
$3.3M
Guiding epilepsy surgery using network models and Stereo EEGR01NS125137 · NINDS · UNIVERSITY OF PENNSYLVANIA · PI BASSETT, DANIELLE SMITH, LITT, BRIAN · 2022 to 2025
$2.8M
Pennsieve: Impactful Multimodal Data Sharing for Epilepsy ResearchU24NS134536 · NINDS · UNIVERSITY OF PENNSYLVANIA · PI Joost B Wagenaar · 2024 to 2026
$2.6M
Scalable methods to quantify epileptic network and guide epilepsy surgeryK99NS138680 · NINDS · UNIVERSITY OF PENNSYLVANIA · PI SINHA, NISHANT · 2024 to 2025
$298k
National Health and Medical Research Council APP1176426National Health and Medical Research Council APP2034258NINDS NIH HHS K99 NS138680NINDS NIH HHS K99NS138680NINDS NIH HHS R01NS116504NINDS NIH HHS R01NS125137NINDS NIH HHS R61NS125568NINDS NIH HHS U24NS134536U.S. Department of Defense W81XWH2210593
6 · The paper itself

Abstract

Intracranial electroencephalographic (iEEG) connectivity analysis is a promising method to localize epileptic networks and guide surgical planning in focal drug-resistant epilepsy. Despite numerous studies exploring its utility, the added value of iEEG connectivity over standard clinical presurgical evaluation remains unclear. We assess the current evidence on the efficacy of iEEG connectivity analyses to improve seizure outcomes following epilepsy surgery through a systematic review and meta-analysis. Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) reporting guidelines, we searched PubMed and Embase for studies (2006-2024) of adult focal drug-resistant epilepsy patients who underwent surgical resection or ablation, reported outcomes at least 1 year postsurgery, and used iEEG connectivity analysis to localize networks. Reviews, nonhuman studies, and studies lacking iEEG connectivity analysis or network localization were excluded. We derived classification metrics (true/false positives/negatives) based on concordance between iEEG findings, clinical localization, and outcome. Subgroup meta-analyses and meta-regressions determined differences by seizure type, lesion status, and analysis approach. Of 2881 studies screened, 25 met criteria (n = 909). The pooled odds ratio comparing seizure outcome prediction using iEEG connectivity versus standard clinical evaluation was 1.36 (95% confidence interval = 1.10-1.69, p = .004), indicating a significant overall benefit. Subgroup analyses found no significant differences by directionality, modeling method (linear/nonlinear), or iEEG epoch (interictal/peri-ictal). Meta-regression revealed greater added value of iEEG connectivity in studies with higher proportions of non-seizure-free patients following surgery for temporal lobe or lesional epilepsy. However, no individual study achieved statistical significance on its own, reflecting limited power and lack of individual patient-level data. Power analysis confirmed that detecting a clinically meaningful effect requires substantially larger, potentially multicenter datasets. iEEG connectivity analysis offers modest but consistent increased value over standard clinical methods to predict seizure freedom in adult patients with focal drug-resistant epilepsy. For clinical translation, we propose recommendations for future studies to address sample size limitations, standardize reporting, and prioritize individual patient-level data sharing.

Indexed as

Drug Resistant EpilepsyElectrocorticographyNerve NetBrain MappingEpilepsyHumansconnectivityepileptic networksiEEGlocalizationsurgery

Identifiers

PMID41770259
PMCPMC13285243

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.