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The identification of abnormal electrographic activity is important in a widerange of neurological disorders, including epilepsy for localisingepileptogenic tissue. However, this identification may be challenging duringnon-seizure (interictal) periods, especially if abnormalities are subtlecompared to the repertoire of possible healthy brain dynamics. Here, weinvestigate if such interictal abnormalities become more salient byquantitatively accounting for the range of healthy brain dynamics in alocation-specific manner. To this end, we constructed a normative map of braindynamics, in terms of relative band power, from interictal intracranialrecordings from 234 subjects (21,598 electrode contacts). We then comparedinterictal recordings from 62 patients with epilepsy to the normative map toidentify abnormal regions. We hypothesised that if the most abnormal regionswere spared by surgery, then patients would be more likely to experiencecontinued seizures post-operatively. We first confirmed that the spatialvariations of band power in the normative map across brain regions wereconsistent with healthy variations reported in the literature. Second, whenaccounting for the normative variations, regions which were spared by surgerywere more abnormal than those resected only in patients with persistentpost-operative seizures (t=-3.6, p=0.0003), confirming our hypothesis. Third,we found that this effect discriminated patient outcomes (AUC=0.75 p=0.0003).Normative mapping is a well-established practice in neuroscientific research.Our study suggests that this approach is feasible to detect interictalabnormalities in intracranial EEG, and of potential clinical value to identifypathological tissue in epilepsy. Finally, we make our normative intracranialmap publicly available to facilitate future investigations in epilepsy andbeyond.

Normative brain mapping of interictal intracranial EEG to localise epileptogenic tissue