Altered neural avalanche spreading in people with drug-resistant epilepsy✰

• DOI: 10.1016/j.neuroimage.2025.121188
• Publication Date: 2025-04-04T15:00:42Z
• Authors: B.M. Sancetta; M.A.G. Matarrese; L. Ricci; J. Lanzone; G. Lippa; M. Nesta; F. Zappasodi; M. Brunetti; V. Di Lazzaro; M. Tombini; G. Assenza

To characterize a peculiar "EEG endophenotype" of drug-resistant epilepsy (DRE) through the graph theory characterization avalanche spatiotemporal spreading properties. We performed analysis and computed transition matrices (ATMs) on 19-channel scalp EEG 120 people with (60 DRE 60 non-DRE) who assumed two anti-seizure medications, comparing such results group 40 healthy subjects (HS). Network topologies ATMs were characterized metrics. an variance to compare aperiodic metrics between HS, non-DRE. Logistic regression was test ability ATM clinical features correctly discriminate PwE according outcome (DRE or non-DRE). exhibited altered as proved by higher mean betweenness centrality, longer characteristic path length lower small-world index (more regular less plastic network topology) than non-DRE HS (p-values from <0.001 0.05). Graph significantly improved yield detecting contributed most model accuracy (0.83) features. Resting-state activity did not deviate characteristics system operating at criticality. detect alterations resting-state networks condition. These findings could open new scenarios for future identification promising biomarkers EEG.