Compensation of Hyperexcitability with Simulation-Based Inference

Joint Public Review:

Summary:

This manuscript couples a 32-parameter model with simulation-based inference (SBI) to identify parameter changes that can compensate for three canonical hyperexcitability perturbations (interneuron loss, recurrent-excitatory sprouting, and intrinsic depolarisation). The study demonstrates a careful implementation of SBI and offers a practical ranking of "compensatory levers" that could, in principle, guide therapeutic strategies for epilepsy and related network disorders.

Strengths:

(1) By analysing three mechanistically distinct hyper-excitable regimes within the same modelling and inference framework, the work reveals how different perturbations require different compensatory interventions.

(2) The authors adopt posterior estimation to systematically rank the efficiency of different mechanisms in balancing hyperexcitability.

(3) Code and data are available.

Weaknesses:

(1) A highly dense presentation of the simulated models and undefined symbols makes it hard for readers outside the modelling community to follow the biological message. An illustration of the models, accompanied by some explanations and references to the main equations and parameters discussed in this paper, would make the first section much more straightforward.

(2) This methodology appears to be a brute-force approach, requiring millions of simulations to tune 32 parameters in a network of 500-700 cells. It isn't scalable. Moreover, the authors did not use cross-validation, which, with a relatively low increase in computational cost, would provide a quantitative measure as to how well it generalizes; this combination raises doubts about both scalability and reliability.

(3) Several parameters remain so broadly distributed after fitting that the model cannot say with confidence which specific changes matter. Therefore, presenting them as "compensatory levers" is somewhat questionable.

(4) Every conclusion is drawn from simulated data; without testing the predictions on recordings, we have no evidence that the proposed interventions would work in real neural tissue. Because today we cannot diagnose which of the three modelled pathological regimes is actually present in vivo, the paper's recommendations cannot yet be used to guide therapy.