Foundation Models for Epileptogenic Zone Identification in Drug-Resistant Epilepsy

Accurate identification of the epileptogenic zone (EZ) is essential for seizure freedom after resective surgery in drug-resistant epilepsy, yet seizure freedom rates remain below 50%. We developed EpiiSLM, a dual foundation model system for EZ identification with stereo-electroencephalography (sEEG), by training a signal foundation model on 104,990 minutes of sEEG recordings from the Montreal Neurological Institute & Hospital, while leveraging all recordings regardless of surgical outcome and anchoring EZ biomarker extraction on non-epileptic signals. A language foundation model then integrates sEEG-derived outputs with multimodal clinical information to produce interpretable predictions. Under leave-one-patient-out evaluation, EpiiSLM achieved 0.978 contact-level positive predictive value (PPV), outperforming the seizure onset zone(SOZ)-as-EZ baseline by 15.1% (p < 0.05), and 100% region-level accuracy; on an external dataset, EpiiSLM achieved 0.857 contact-level PPV. EpiiSLM requires only one night of interictal sleep data, suggesting potential to reduce invasive sEEG monitoring duration and improve surgical outcomes.

Open-Set Multivariate Time-Series Anomaly Detection

Numerous methods for time series anomaly detection (TSAD) methods have emerged in recent years. Most existing methods are unsupervised and assume the availability of normal training samples only, while few supervised methods have shown superior performance by incorporating labeled anomalous samples in the training phase. However, certain anomaly types are inherently challenging for unsupervised methods to differentiate from normal data, while supervised methods are constrained to detecting anomalies resembling those present during training, failing to generalize to unseen anomaly classes. This paper is the first attempt in providing a novel approach for the open-set TSAD problem, in which a small number of labeled anomalies from a limited class of anomalies are visible in the training phase, with the objective of detecting both seen and unseen anomaly classes in the test phase. The proposed method, called Multivariate Open-Set timeseries Anomaly Detection (MOSAD) consists of three primary modules: a Feature Extractor to extract meaningful time-series features; a Multi-head Network consisting of Generative-, Deviation-, and Contrastive heads for capturing both seen and unseen anomaly classes; and an Anomaly Scoring module leveraging the insights of the three heads to detect anomalies. Extensive experiments on three real-world datasets consistently show that our approach surpasses existing methods under various experimental settings, thus establishing a new state-of-the-art performance in the TSAD field.