Degenerate time-dependent network dynamics anticipate seizures in human epileptic brain

Epileptic seizures are known to follow specific changes in brain dynamics. While some algorithms can nowadays robustly detect these changes, a clear understanding of the mechanism by which these alterations occur and generate seizures is still lacking. Here, we provide cross-validated evidence that such changes are initiated by an alteration of physiological network state dynamics. Specifically, our analysis of long intracranial EEG recordings from a group of 10 patients identifies a critical phase of a few hours in which time-dependent network states become less variable (“degenerate”) and is followed by a global functional connectivity reduction before seizure onset. This critical phase is characterized by an abnormal occurrence of highly correlated network instances and is shown to particularly affect the activity of resection regions in patients with validated postsurgical outcome. Our approach characterizes pre-seizure networks dynamics as a cascade of two sequential events providing new insights into seizure prediction and control.