High-Frequency Electroencephalographic Oscillations Correlate With Outcome of Epilepsy Surgery
High-Frequency Electroencephalographic Oscillations Correlate With Outcome of Epilepsy Surgery
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DOI：
10.1002/ana.21847
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发表时间：
2010-02-01
影响因子：
11.2
通讯作者：
Gotman, Jean
中科院分区：
文献类型：
--
作者：
Jacobs, Julia;Zijlmans, Maeike;Gotman, Jean
目的：脑内脑电图（EEG）中的高频振荡（HFOs）与癫痫发作起始区（SOZ）有关。我们调查是否HFOs可以划定致痫区域，即使在SOZ外的相关切除HFO生成区域与surgical outcome.Methods：20例谁接受了手术切除的药物难治性癫痫进行了研究。所有患者均接受了术前脑内EEG（500 Hz滤波器和2，000 Hz采样率）、术后至少12个月随访和术后磁共振成像（MRI）。HFO（波纹，80- 250 Hz;快速波纹，> 250 Hz）在5至10分钟的慢波睡眠期间被视觉识别。术后MRI评估切除与非切除区域的HFO和发作间期棘波的发生率和程度，并与手术结果（恩格尔的分类）进行比较。我们还评估了去除SOZ在手术outcome.Results方面的预测价值：平均随访时间为22.7个月。8例患者的手术结局良好（Engel 1级和2级），12例较差（3级和4级）。结果良好的患者切除HFO生成区域的比例明显高于结果不良的患者。没有这样的差异被视为尖峰生成区域或SOZ.Interpretation：去除HFO生成区域和良好的手术结果之间的相关性表明，HFO可以被用作癫痫发生的标记，可能比尖峰生成区域或SOZ更准确。在大部分HFO生成组织保留的患者中，手术结局较差。神经网络2010;67：209-220
Objective: High-frequency oscillations (HFOs) in the intracerebral electroencephalogram (EEG) have been linked to the seizure onset zone (SOZ). We investigated whether HFOs can delineate epileptogenic areas even outside the SOZ by correlating the resection of HFO-generating areas with surgical outcome.Methods: Twenty patients who underwent a surgical resection for medically intractable epilepsy were studied. All had presurgical intracerebral EEG (500Hz filter and 2,000Hz sampling rate), at least 12-month postsurgical follow-up, and a postsurgical magnetic resonance imaging (MRI). HFOs (ripples, 80-250Hz; fast ripples, >250Hz) were identified visually during 5 to 10 minutes of slow-wave sleep. Rates and extent of HFOs and interictal spikes in resected versus nonresected areas, assessed on postsurgical MRIs, were compared with surgical outcome (Engel's classification). We also evaluated the predictive value of removing the SOZ in terms of surgical outcome.Results: The mean duration of follow-up was 22.7 months. Eight patients had good (Engel classes 1 and 2) and 12 poor (classes 3 and 4) surgical outcomes. Patients with a good outcome had a significantly larger proportion of HFO-generating areas removed than patients with a poor outcome. No such difference was seen for spike-generating regions or the SOZ.Interpretation: The correlation between removal of HFO-generating areas and good surgical outcome indicates that HFOs could be used as a marker of epileptogenicity and may be more accurate than spike-generating areas or the SOZ. In patients in whom the majority of HFO-generating tissue remained, a poor surgical outcome occurred. ANN NEUROL 2010;67:209-220