Differentiation of specific ripple patterns helps to identify epileptogenic areas for surgical procedures
Differentiation of specific ripple patterns helps to identify epileptogenic areas for surgical procedures
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DOI：
10.1016/j.clinph.2013.11.030
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发表时间：
2014-07-01
影响因子：
4.7
通讯作者：
Jacobs, Julia
中科院分区：
文献类型：
--
作者：
Kerber, Karolin;Duempelmann, Matthias;Jacobs, Julia
目的：80-500 Hz 的高频振荡 (HFO) 是癫痫区域有希望的标志物。几项回顾性研究报告称，手术切除产生 HFO 的区域与良好的癫痫发作结果相关。最近的报告表明，纹波（80-200 Hz）HFO 模式与不同的背景脑电图活动共存。我们假设共存的背景脑电图模式可以区分生理性波动和癫痫性波动。方法：对 22 名患者的颅内脑电图记录中的 HFO 发生率进行了分析。此外，根据与平坦或振荡背景活动共存，对每个通道的波纹模式进行分类。进行多变量分析以确定去除显示上述脑电图标记的区域是否与癫痫发作结果相关。结果：去除产生高频率“快速波纹（>200 Hz）”和“平坦背景活动波纹”的区域与无癫痫发作结果显着相关。相比之下，去除高频率的“波纹”或“连续振荡背景中的波纹图案”与癫痫结果没有显着相关。结论：振荡背景活动中出现的波纹可能暗示生理活动，而平坦背景上的波纹则反映癫痫活动。意义：考虑共存的背景图案可以改善使用波纹振荡对致癫痫区域的描绘。 (C) 2013 年国际临床神经生理学联合会。由爱思唯尔爱尔兰有限公司出版。保留所有权利。
Objective: High frequency oscillations (HFOs) at 80-500 Hz are promising markers of epileptic areas. Several retrospective studies reported that surgical removal of areas generating HFOs was associated with a good seizure outcome. Recent reports suggested that ripple (80-200 Hz) HFO patterns co-existed with different background EEG activities. We hypothesized that the coexisting background EEG pattern may distinguish physiological from epileptic ripples.Methods: Rates of HFOs were analyzed in intracranial EEG recordings of 22 patients. Additionally, ripple patterns were classified for each channel depending either as coexisting with a flat or oscillatory background activity. A multi-variate analysis was performed to determine whether removal of areas showing the above EEG markers correlated with seizure outcome.Results: Removal of areas generating high rates of 'fast ripples (>200 Hz)' and ' ripples on a flat background activity' showed a significant correlation with a seizure-free outcome. In contrast, removal of high rates of 'ripples' or 'ripple patterns in a continuously oscillating background' was not significantly associated with seizure outcome.Conclusion: Ripples occurring in an oscillatory background activity may be suggestive of physiological activity, while those on a flat background reflect epileptic activity.Significance: Consideration of coexisting background patterns may improve the delineation of the epileptogenic areas using ripple oscillations. (C) 2013 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.