ORIGINAL RESEARCH article
Front. Neuroinform.
Volume 19 - 2025 | doi: 10.3389/fninf.2025.1661617
Epileptic Brain Imaging by Source Localisation CLARA supported by Ictal-Based Semiology and VEEG in Resource-Limited Settings
Provisionally accepted
Amir F Al-Bakri1*
Ahmed Tahseen Muslim2
Moneer Faraj3Wamedh Esam2Radana Vilimkova Kahankova4Dariusz Mikolajewski5
Waldemar Karwowski6
Aleksandra Dagmara Kawala-Sterniuk7*- 1University of Babylon, Hillah, Iraq
- 2Al-Witri Hospital for Neurosciences, Baghdad, Iraq
- 3University of Baghdad, Baghdad, Iraq
- 4Vysoka skola banska-Technicka univerzita Ostrava Fakulta elektrotechniky a informatiky, Ostrava, Czechia
- 5Uniwersytet Kazimierza Wielkiego w Bydgoszczy, Bydgoszcz, Poland
- 6University of Central Florida, Orlando, United States
- 7Wroclaw University of Science and Technology, Wroclaw, Poland
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This retrospective study aims to assess the concordance between the symptomatogenic zone identified by ictal semiology and a new distributed electrical source localization technique called CLARA, and to evaluate their accuracy in postsurgical outcomes for epilepsy patients.Initially, sixteen patients with at least three seizures underwent subjective analysis of ictal semiology supported by video electroencephalograph (VEEG). Neurologists, neurophysiologists, and radiologists determined the presumed zone at the lobar level. CLARA was then applied to identify the computed zone using ictal and/or interictal biomarker activities. For thirteen patients, the qualitative comparison revealed a 77% concordance and 23% partial concordance between the presumed and computed zones. Postsurgical outcomes showed complete seizure freedom for a patient with cavernoma following complete resection of the CLARA area, while patients with incomplete resection continued to experience epilepsy. The study demonstrates the utility 1 Al-Bakri et al. Epileptic Brain Imaging by Source Localisation CLARA. . .standard methods such as PET, SPECT, fMRI, and MRI. Its promising results suggest the potential for improving presurgical decision accuracy. Implementing CLARA in preoperative evaluation could enhance the identification of epileptogenic zones, leading to more effective surgical interventions and better outcomes for patients with epilepsy. This technique could be especially valuable in resource-limited centers, where advanced medical equipment or specialized personnel may be unavailable, and holds the potential to deliver promising results.
Keywords: Epilepsy, Brain Signals, vEEG, brain imaging, CLARA = classical LORETA analysis recursively applied
Received: 08 Jul 2025; Accepted: 12 Aug 2025.
Copyright: © 2025 Al-Bakri, Muslim, Faraj, Esam, Vilimkova Kahankova, Mikolajewski, Karwowski and Kawala-Sterniuk. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Amir F Al-Bakri, University of Babylon, Hillah, Iraq
Aleksandra Dagmara Kawala-Sterniuk, Wroclaw University of Science and Technology, Wroclaw, Poland
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.