Expert system for pharmacological epilepsy treatment prognosis and optimal medication dose prescription: computational model and clinical application

Epilepsy is a debilitating neurological condition that affects approximately 1% of the population. In most cases, it is treatable by anti-epileptic drugs (AED) but still about 30% of the patients do not respond sufficiently to medication and continue suffering from seizures. Even for those who respond to AED treatment, determining the optimal dose can require lengthy periods of trial, error and adjustments. To address these challenges, the main objective of the present study is to find a biomarker for quantification of the level of responsiveness of people with epilepsy to anti-epileptic drugs on a personal level. We use a computational model of connected bistable units to generate and validate "in silico" a robust biomarker hypothesis. Next we applied the biomarker to EEG from a cohort of patients with known reaction to medication. The model showed that the aggregated functional connectivity is a critically important observable that reflects the state of epilepsy. Applied to the clinical data we were able to derive a criterion for pharmacological responsiveness as well as a paradigm for assessing the optimal medication dose.