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Identifying abnormal electroencephalographic activity is crucial in diagnosisand treatment of epilepsy. Recent studies showed that decomposing brainactivity into periodic (oscillatory) and aperiodic (trend across allfrequencies) components may illuminate drivers of changes in spectral activity.  Using iEEG data from 234 subjects, we constructed a normative map andcompared this with a separate cohort of 63 patients with refractory focalepilepsy being considered for neurosurgery. The normative map was computedusing three approaches: (i) relative complete band power, (ii) relative bandpower with the aperiodic component removed (iii) the aperiodic exponent.Corresponding abnormalities were also calculated for each approach in theseparate patient cohort. We investigated the spatial profiles of the threeapproaches, assessed their localizing ability, and replicated our findings in aseparate modality using MEG.  The normative maps of relative complete band power and relative periodic bandpower had similar spatial profiles. In the aperiodic normative map, exponentvalues were highest in the temporal lobe. Abnormality estimated through thecomplete band power robustly distinguished between good and bad outcomepatients. Neither periodic band power nor aperiodic exponent abnormalitiesdistinguished seizure outcome groups. Combining periodic and aperiodicabnormalities improved performance, similar to the complete band powerapproach.  Our findings suggest that sparing cerebral tissue that generatesabnormalities in either periodic or aperiodic activity may lead to a poorsurgical outcome. Both periodic and aperiodic abnormalities are necessary todistinguish patient outcomes, with neither sufficient in isolation. Futurestudies could investigate whether periodic or aperiodic abnormalities areaffected by the cerebral location or pathology.

Identifying epileptogenic abnormality by decomposing intracranial EEG and MEG power spectra