High frequency oscillations as markers of epileptogenic tissue - End of the party?
High frequency oscillations as markers of epileptogenic tissue - End of the party?
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DOI：
10.1016/j.clinph.2019.01.016
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发表时间：
2019-05-01
影响因子：
4.7
通讯作者：
Sarnthein, Johannes
中科院分区：
文献类型：
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作者：
Fedele, Tommaso;Ramantani, Georgia;Sarnthein, Johannes
20多年的热情研究帮助在动物模型和难治性局灶性癫痫患者中建立了高频振荡(HFO)作为一种有前途的致痫生物标志物(Jacobs等人，2010，Jacobs等人，2012，Fedele等人，2007b，Frauscher等人，2017，Zijlmann等人，2017，Gotman，2018)。有几项研究依靠发作间期较高的HFO发生率来确定癫痫发作起始区(SOZ)，从而检测接受术前检查或癫痫手术的患者的致痫组织(Jacobs等人，2010，Jacobs等人，2012，Frauscher等人，2017，Zijlmann等人，2017)。最新报告显示，癫痫手术后残留的HFO有可能预测单个患者的不良癫痫结果(van‘t Krouster等人，2015)，强调了切除后ECoG对最佳癫痫控制的关键作用(van’t Krouster等人，2017)。在一系列难治性局灶性癫痫队列中将大脑区域归类为“SOZ”和“非SOZ”的指导思想是，HFO通常与致痫能力有很强的相关性，因此在SOZ中更常见。这些研究中的HFO发生率被发现取决于几个因素，例如，抗癫痫药物的组合及其在术前检查期间的停药(Zijlmann等人，2009年)，睡眠稳态(von Ellenrieder等人，2017年)，或大脑不同区域的定位(Gurgain等人，2018年)。然而，综上所述，这些研究提供了HFO与致痫区(EZ)密切相关的一致证据，并为以前瞻性的方式潜在地使用HFO指导个别患者的手术计划铺平了道路(Fedele等人，2007b)。然而，最近的报告(Gliske等人，2018年，Jacobs等人，2018年，Roehri等人，2018年)对HFO定位诊断的临床实用性提出了严重的质疑。派对结束了吗？考虑到二十年来对HFO的热情和繁荣的研究，在宣布派对结束、清理和回家之前，我们想要花一些时间来思考更多。我们将对三个关键问题进行三次长叹，即：
Over 20 years of enthusiastic research have served to establish high frequency oscillations (HFO) as a promising biomarker of epileptogenicity, both in animal models and in refractory focal epilepsy patients (Jacobs et al., 2010, Jacobs et al., 2012, Fedele et al., 2017b, Frauscher et al., 2017, Zijlmans et al., 2017, Gotman, 2018). Several studies have relied on higher interictal HFO occurrence rates to identify the seizure onset zone (SOZ), and thus to detect the epileptogenic tissue in patients undergoing presurgical workup or epilepsy surgery (Jacobs et al., 2010, Jacobs et al., 2012, Frauscher et al., 2017, Zijlmans et al., 2017). Latest reports showed that residual HFO after epilepsy surgery have the potential to predict poor seizure outcome in the individual patient (van't Klooster et al., 2015), emphasizing the key role of post-resection ECoG for optimal seizure control (van't Klooster et al., 2017). Classifying brain regions as “SOZ” and “non-SOZ” in a series of refractory focal epilepsy cohorts was guided by the notion that HFO generally present a strong correlation with epileptogenicity and are thus more frequently encountered in the SOZ. HFO rates in these studies were found to depend on several factors, eg, antiepileptic drug combinations and their withdrawal during presurgical workup (Zijlmans et al., 2009), sleep homeostasis (von Ellenrieder et al., 2017), or localization in different regions throughout the brain (Guragain et al., 2018). Nevertheless, taken together, these studies provided converging evidence of the strong association of HFO with the epileptogenic zone (EZ) and paved the way towards the potential use of HFO, in a prospective way, to guide surgery planning in the individual patient (Fedele et al., 2017b).However, recent reports (Gliske et al., 2018, Jacobs et al., 2018, Roehri et al., 2018) have raised serious doubts about the clinical utility of localization diagnosis deriving from HFO. Is the party over? Mindful of twenty years of enthusiastic and prospering research on HFO and before declaring the party over, cleaning up, and going home, we would like to take some time for some more thoughts. We will have three long sighs pondering on three key issues, namely: