Seizure forecasting with epilepsy cycles: On the causality of forecasting pipelines

Clinically beneficial seizure forecasting requires algorithms that function prospectively, using only past data. Our findings reveal a substantial performance gap between theoretical (noncausal, retrospective) performance and realistic (causal, prospective) capabilities. This suggests that prior studies may have overestimated forecasting accuracy. Future research must focus on developing novel cycle-extraction methods that remain robust under real-time prospective conditions.