Graph-Based Approaches to Learning Epileptogenic Zone Localization Using Stereo-EEG Recordings

Accurate identification of the epileptogenic zone (EZ) is essential for seizure freedom after resective surgery in drug-resistant epilepsy, yet seizure freedom rates remain below 50%. We developed EpiiSLM, a dual foundation model system for EZ identification with stereo-electroencephalography (sEEG), by training a signal foundation model on 104,990 minutes of sEEG recordings from the Montreal Neurological Institute & Hospital, while leveraging all recordings regardless of surgical outcome and anchoring EZ biomarker extraction on non-epileptic signals. A language foundation model then integrates sEEG-derived outputs with multimodal clinical information to produce interpretable predictions. Under leave-one-patient-out evaluation, EpiiSLM achieved 0.978 contact-level positive predictive value (PPV), outperforming the seizure onset zone(SOZ)-as-EZ baseline by 15.1% (p < 0.05), and 100% region-level accuracy; on an external dataset, EpiiSLM achieved 0.857 contact-level PPV. EpiiSLM requires only one night of interictal sleep data, suggesting potential to reduce invasive sEEG monitoring duration and improve surgical outcomes.

Seizure detection and prediction from EEG are clinically important but challenging because seizures are rare, temporally localized, and propagate as coordinated events across multiple channels. Recent dynamic graph neural networks model this by running a temporal model over a sequence of per-time-step pairwise channel edges. However, this pairwise construction misses the spatiotemporal coupling that constitutes a seizure, at substantial training cost. We propose HyBrain, which summarizes spatiotemporal EEG evidence through a small set of soft hyperedges rather than pairwise edges. A per-channel Mamba backbone produces one token per (channel, second), and a spatiotemporal hyperedge block pools these tokens into E_h shared group embeddings through soft memberships and broadcasts them back. The same encoder serves three downstream tasks: window-based detection, one-second point-wise detection, and preictal seizure prediction. On TUSZ and CHB-MIT, HyBrain achieves the best AUROC on every reported setting against ten baselines, with the largest gap on long-clip preictal prediction. It also matches the most efficient baselines in training time and peak GPU memory. A qualitative analysis shows that even a single learned hyperedge cleanly captures the preictal -> ictal -> postictal trajectory on a real seizure clip.

Seizure detection from EEG signals is highly challenging due to complex spatiotemporal dynamics and extreme inter-patient variability. To model them, recent methods construct dynamic graphs via statistical correlations, predefined similarity measures, or implicit learning, yet rarely account for EEG's noisy nature. Consequently, these graphs usually contain redundant or task-irrelevant connections, undermining model performance even with state-of-the-art architectures. In this paper, we present a new perspective for EEG seizure detection: jointly learning denoised dynamic graph structures and informative spatial-temporal representations guided by the Information Bottleneck (IB). Unlike prior approaches, our graph constructor explicitly accounts for the noisy characteristics of EEG data, producing compact and reliable connectivity patterns that better support downstream seizure detection. To further enhance representation learning, we employ a self-supervised Graph Masked AutoEncoder that reconstructs masked EEG signals based on dynamic graph context, promoting structure-aware and compact representations aligned with the IB principle. Bringing things together, we introduce Information Bottleneck-guided EEG SeizuRE DetectioN via SElf-Supervised Learning (IRENE), which explicitly learns dynamic graph structures and interpretable spatial-temporal EEG representations. IRENE addresses three core challenges: (i) Identifying the most informative nodes and edges; (ii) Explaining seizure propagation in the brain network; and (iii) Enhancing robustness against label scarcity and inter-patient variability. Extensive experiments on benchmark EEG datasets demonstrate that our method outperforms state-of-the-art baselines in seizure detection and provides clinically meaningful insights into seizure dynamics. The source code is available at https://github.com/LabRAI/IRENE.