Physiological and pathological high frequency oscillations in focal epilepsy.
Physiological and pathological high frequency oscillations in focal epilepsy.
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DOI：
10.1002/acn3.618
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发表时间：
2018-09
影响因子：
5.3
通讯作者：
Worrell G
中科院分区：
文献类型：
--
作者：
Cimbalnik J;Brinkmann B;Kremen V;Jurak P;Berry B;Gompel JV;Stead M;Worrell G
本研究调查了高频振荡（HFO; 65-600 Hz）作为致痫性脑的生物标志物，并探讨了其临床转化的三个障碍：（1）区分病理性HFO（pathHFO）和生理性HFO（physHFO）。(2)将单个电极下的组织分类为致癫痫（3）在实验室间重现结果。我们使用颅内脑电图（iEEG）记录了90例局灶性癫痫患者和11例非癫痫患者的HFO。在9例癫痫患者中，假定的physHFO由认知或运动任务引起。使用经验证的检测器识别HFO。开发了使用HFO特征的支持向量机（SVM），以将各个电极下的组织分类为正常或致癫痫。自发性生理HFO、任务诱发性生理HFO和路径HFO的振幅、频率和持续时间分布存在显著重叠，但路径HFO的振幅更高（P < 0.0001）。高γ波HFO与癫痫发作区（SOZ）相关性最强，70%的癫痫患者在SOZ电极上HFO升高（P < 0.0001）。未能切除产生高伽马路径HFO的组织与不良结局相关（P < 0.0001）。SVM将单个电极分类为致癫痫，使用SOZ作为靶点，灵敏度为63.9%，特异性为73.7%。发作间期HFO（65-600 Hz）的范围比以前认识到的更广，是致痫性脑的生物标志物，并与SOZ和手术结果相关。将HFO分类为生理或病理仍然具有挑战性。在单个电极下对组织进行分类被证明是可行的。开源数据和算法为未来的研究提供了资源。
This study investigates high‐frequency oscillations (HFOs; 65–600 Hz) as a biomarker of epileptogenic brain and explores three barriers to their clinical translation: (1) Distinguishing pathological HFOs (pathHFO) from physiological HFOs (physHFO). (2) Classifying tissue under individual electrodes as epileptogenic (3) Reproducing results across laboratories. We recorded HFOs using intracranial EEG (iEEG) in 90 patients with focal epilepsy and 11 patients without epilepsy. In nine patients with epilepsy putative physHFOs were induced by cognitive or motor tasks. HFOs were identified using validated detectors. A support vector machine (SVM) using HFO features was developed to classify tissue under individual electrodes as normal or epileptogenic. There was significant overlap in the amplitude, frequency, and duration distributions for spontaneous physHFO, task induced physHFO, and pathHFO, but the amplitudes of the pathHFO were higher (P < 0.0001). High gamma pathHFO had the strongest association with seizure onset zone (SOZ), and were elevated on SOZ electrodes in 70% of epilepsy patients (P < 0.0001). Failure to resect tissue generating high gamma pathHFO was associated with poor outcomes (P < 0.0001). A SVM classified individual electrodes as epileptogenic with 63.9% sensitivity and 73.7% specificity using SOZ as the target. A broader range of interictal pathHFO (65–600 Hz) than previously recognized are biomarkers of epileptogenic brain, and are associated with SOZ and surgical outcome. Classification of HFOs into physiological or pathological remains challenging. Classification of tissue under individual electrodes was demonstrated to be feasible. The open source data and algorithms provide a resource for future studies.
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影响因子：
14.5
作者：
Blanco, Justin A.;Stead, Matt;Worrell, Gregory A.
通讯作者：
Worrell, Gregory A.
影响因子：
4.7
作者：
Gardner, Andrew B.;Worrell, Greg A.;Litt, Brian
通讯作者：
Litt, Brian
影响因子：
11.2
作者：
Jacobs, Julia;Zijlmans, Maeike;Gotman, Jean
通讯作者：
Gotman, Jean
影响因子：
5.6
作者：
Bell ML;Rao S;So EL;Trenerry M;Kazemi N;Stead SM;Cascino G;Marsh R;Meyer FB;Watson RE;Giannini C;Worrell GA
通讯作者：
Worrell GA
影响因子：
5.7
作者：
Fischl, Bruce
通讯作者：
Fischl, Bruce