Prediction of human epileptic seizures based on optimization and phase changes of brain electrical activity

The phenomenon of epilepsy, one of the most common neurological disorders, constitutes a unique opportunity to study the dynamics of spatiotemporal state transitions in real, complex, nonlinear dynamical systems. We previously demonstrated that measures of chaos and angular frequency obtained from electroencephalographic (EEG) signals generated by critical sites in the cerebral cortex converge progressively (dynamical entrainment) from the asymptomatic interictal state to the ictal state (seizure) [L.D. Iasemidis, P. Pardalos, J.C. Sackellares and D.-S. Shiau (2001). Quadratic binary programming and dynamical system approach to determine the predictability of epileptic seizures. J. Combinatorial Optimization, 5, 9-26; L.D. Iasemidis, D.-S. Shiau, P.M. Pardalos and J.C. Sackellares (2002). Phase entrainment and predictability of epileptic seizures. In: P.M. Pardalos and J. Principe (Eds.), Biocomputing, pp. 59-84. Kluwer Academic Publishers]. This observation suggests the possibility of developing algorithms to predict seizures. One of the central points of those investigations was the application of optimization theory, specifically quadratic zero-one programming, for the selection of the cortical sites that exhibit preictal dynamical entrainment. In this study we present results from the application of this methodology to the prediction of epileptic seizures. Analysis of continuous, long-term (18-140 h), multielectrode EEG recordings from 5 patients resulted in the prediction of 88% of the impending 50 seizures, on average about 83 min prior to seizure onset, with an average false warning rate of one every 5.26 h. These results suggest that this seizure prediction algorithm performs well enough to be used in diagnostic and therapeutic applications in epileptic patients. Similar algorithms may be useful for certain spatiotemporal state transitions in other physical and biological systems.