Podwójna analiza energii zapisów wewnątrzczaszkowych: strefy início napadu i regiony dominujące energią u pacjentów z lekooporną epilepsją

Objective To determine whether absolute ictal energy on intracranial EEG identifies brain regions whose epileptogenic involvement is attenuated under existing baseline-normalized, dynamic-systems, and event-based frameworks. Approach Intracranial EEG from 56 patients (five centers; 21 SEEG, 35 ECoG) was analyzed using the Teager-Kaiser Energy Operator computed as z-scored and raw envelopes; energy-dominant network regions (EDNRs) were defined as electrodes whose raw-energy rank exceeded their z-score rank by at least 2 positions. Hilbert decomposition characterized instantaneous amplitude and frequency. Main results EDNRs were identified in 51 of 56 patients (91%; mean 3.4). Hilbert decomposition revealed elevated baseline amplitude in EDNRs relative to both non-involved regions ( p Significance Absolute ictal energy identifies an epileptogenic network component with elevated baseline amplitude attenuated under baseline-normalized metrics. The dual-metric framework defines a complementary energy-based axis and establishes the second layer of a two-layer approach with seizure onset and propagation mapping as the first layer. EDNR detectability scales with electrode count, directly relevant to SEEG implantation strategy and to network-level inferences from heterogeneously covered cohorts. Highlights Dual-metric Teager-Kaiser energy operator (TKEO) identifies seizure onset zones and energy-dominant network regions Energy-dominant network regions (EDNRs) were identified in 91% of 56 patients across five epilepsy centers EDNRs combine highest baseline amplitude with seizure-frequency dynamics; detection scales with electrode count