Predicting seizure freedom is essential for tailoring epilepsy treatment. But accurate prediction remains challenging with traditional methods, especially with diverse patient populations. This study developed a deep learning-based graph neural network (GNN) model to predict seizure freedom from stereo electroencephalography (sEEG) data in patients with refractory epilepsy. We utilized high-quality sEEG data from 15 pediatric patients to train a deep learning model that can accurately predict seizure freedom outcomes and advance understanding of brain connectivity at the seizure onset zone. Our model integrates local and global connectivity using graph convolutions with multi-scale attention mechanisms to capture connections between difficult-to-study regions such as the thalamus and motor regions. The model achieved an accuracy of 92.4% in binary class analysis, 86.6% in patient-wise analysis, and 81.4% in multi-class analysis. Node and edge-level feature analysis highlighted the anterior cingulate and frontal pole regions as key contributors to seizure freedom outcomes. The nodes identified by our model were also more likely to coincide with seizure onset zones. Our findings underscore the potential of new connectivity-based deep learning models such as GNNs for enhancing the prediction of seizure freedom, predicting seizure onset zones, connectivity analysis of the brain during seizure, as well as informing AI-assisted personalized epilepsy treatment planning.

In this work, we present a neuromorphic system that combines for the first time a neural recording headstage with a signal-to-spike conversion circuit and a multi-core spiking neural network (SNN) architecture on the same die for recording, processing, and detecting High Frequency Oscillations (HFO), which are biomarkers for the epileptogenic zone. The device was fabricated using a standard 0.18$\mu$m CMOS technology node and has a total area of 99mm$^{2}$. We demonstrate its application to HFO detection in the iEEG recorded from 9 patients with temporal lobe epilepsy who subsequently underwent epilepsy surgery. The total average power consumption of the chip during the detection task was 614.3$\mu$W. We show how the neuromorphic system can reliably detect HFOs: the system predicts postsurgical seizure outcome with state-of-the-art accuracy, specificity and sensitivity (78%, 100%, and 33% respectively). This is the first feasibility study towards identifying relevant features in intracranial human data in real-time, on-chip, using event-based processors and spiking neural networks. By providing "neuromorphic intelligence" to neural recording circuits the approach proposed will pave the way for the development of systems that can detect HFO areas directly in the operation room and improve the seizure outcome of epilepsy surgery.