Removing high-frequency oscillations
Removing high-frequency oscillations
复制标题
消除高频振荡
作者：
J. Jacobs;Joyce Y. Wu;P. Perucca;R. Zelmann;M. Mader;F. Dubeau;G. Mathern;A. Schulze;J. Gotman
目的通过前瞻性多中心临床试验，评价发作间期高频振荡（HFO）在癫痫手术中预测术后癫痫发作结局的价值。方法：我们假设，在手术计划包括大部分HFO生成脑组织的患者中，可以预期无癫痫结局，而在仅计划切除少数此类区域的患者中，可以预期癫痫结局较差。在1年期间，纳入了来自3个三级癫痫中心的52例患者。在慢波睡眠期间，2个中心的慢性颅内EEG和1例患者的急性术中皮层电图自动检测到纹波（80-250 Hz）和快纹波（250-500 Hz）。结果在所有患者的组水平上，切除HFO生成区域与无复发结局之间存在相关性。然而，中心特异性分析未发现相关性，仅36例患者（67%）的癫痫发作结局的个体化描述是真实的。此外，一些患者在没有去除大部分HFO生成组织的情况下变得无脓肿。影响因素的调查，包括视觉和自动分析的比较，使用阈值分析的区域具有高HFO活性，并排除接触边界切除，没有导致改善的精确性。结论在个体患者水平上，不可能预测所有患者的结局。这可能是由于所使用的分析技术。或者，HFO对癫痫组织的特异性可能低于早期研究所表明的。
Objective To evaluate the use of interictal high-frequency oscillations (HFOs) in epilepsy surgery for prediction of postsurgical seizure outcome in a prospective multicenter trial. Methods We hypothesized that a seizure-free outcome could be expected in patients in whom the surgical planning included the majority of HFO-generating brain tissue while a poor seizure outcome could be expected in patients in whom only a few such areas were planned to be resected. Fifty-two patients were included from 3 tertiary epilepsy centers during a 1-year period. Ripples (80–250 Hz) and fast ripples (250–500 Hz) were automatically detected during slow-wave sleep with chronic intracranial EEG in 2 centers and acute intraoperative electrocorticography in 1 patient. Results There was a correlation between the removal of HFO-generating regions and seizure-free outcome at the group level for all patients. No correlation was found, however, for the center-specific analysis, and an individual prognostication of seizure outcome was true in only 36 patients (67%). Moreover, some patients became seizure-free without removal of the majority of HFO-generating tissue. The investigation of influencing factors, including comparisons of visual and automatic analysis, using a threshold analysis for areas with high HFO activity, and excluding contacts bordering the resection, did not result in improved prognostication. Conclusions On an individual patient level, a prediction of outcome was not possible in all patients. This may be due to the analysis techniques used. Alternatively, HFOs may be less specific for epileptic tissue than earlier studies have indicated.
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影响因子：
8.4
作者：
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通讯作者：
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作者：
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