Interictal scalp fast oscillations as a marker of the seizure onset zone
Interictal scalp fast oscillations as a marker of the seizure onset zone
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DOI：
10.1212/wnl.0b013e318228bee2
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发表时间：
2011-08-01
期刊：
影响因子：
9.9
通讯作者：
Gotman, J.
中科院分区：
文献类型：
--
作者：
Andrade-Valenca, L. P.;Dubeau, F.;Gotman, J.
目的：本研究旨在探讨局灶性癫痫患者的头皮脑电图是否能记录到频率高于传统脑电图的振荡，并分析这些振荡与发作间期放电和发作起始区（SOZ）的关系。我们分析了伽马（40-80 Hz）和涟漪（>80 Hz）振荡的速率，它们与尖峰的共同出现，SOZ内外快速振荡的通道数量，以及伽马、纹波和尖峰确定SOZ.Results的特异性、灵敏度和准确性：伽马和纹波经常与尖峰共同出现（77.5%和63%的病例）。对于所有事件，SOZ内发生事件的通道比例始终高于SOZ外：尖峰（100% vs 70%）、伽马（82% vs 33%）和波纹（48% vs 11%）; p < 0.0001。平均利率（事件/分钟）在SOZ内高于SOZ外：尖峰（2.64 +/- 1.70 vs 0.69 +/- 0.26，p = 0.02）、伽马（0.77 +/- 0.71 vs 0.20 +/- 0.25，p = 0.02）和波纹（0.08 +/- 0.12 vs 0.04 +/- 0.09，p = 0.04）。识别SOZ的灵敏度为棘波100%，伽马82%，波纹48%;特异性为棘波30%，伽马68%，波纹89%;准确性为棘波43%，伽马70%，波纹81%。具有伽马和涟漪快速振荡的通道的速率和比例在SOZ内较高，表明它们可以用作SOZ的发作间期头皮EEG标记。这些快速振荡不太敏感，但比尖峰更具体和准确地描绘SOZ。神经病学（R）2011;77：524-531
Objective: This study aims to identify if oscillations at frequencies higher than the traditional EEG can be recorded on the scalp EEG of patients with focal epilepsy and to analyze the association of these oscillations with interictal discharges and the seizure onset zone (SOZ).Methods: The scalp EEG of 15 patients with focal epilepsy was studied. We analyzed the rates of gamma (40-80 Hz) and ripple (>80 Hz) oscillations, their co-occurrence with spikes, the number of channels with fast oscillations inside and outside the SOZ, and the specificity, sensitivity, and accuracy of gamma, ripples, and spikes to determine the SOZ.Results: Gamma and ripples frequently co-occurred with spikes (77.5% and 63% of cases). For all events, the proportion of channels with events was consistently higher inside than outside the SOZ: spikes (100% vs 70%), gamma (82% vs 33%), and ripples (48% vs 11%); p < 0.0001. The mean rates (events/min) were higher inside than outside the SOZ: spikes (2.64 +/- 1.70 vs 0.69 +/- 0.26, p = 0.02), gamma (0.77 +/- 0.71 vs 0.20 +/- 0.25, p = 0.02), and ripples (0.08 +/- 0.12 vs 0.04 +/- 0.09, p = 0.04). The sensitivity to identify the SOZ was spikes 100%, gamma 82%, and ripples 48%; the specificity was spikes 30%, gamma 68%, and ripples 89%; and the accuracy was spikes 43%, gamma 70%, and ripples 81%.Conclusion: The rates and the proportion of channels with gamma and ripple fast oscillations are higher inside the SOZ, indicating that they can be used as interictal scalp EEG markers for the SOZ. These fast oscillations are less sensitive but much more specific and accurate than spikes to delineate the SOZ. Neurology (R) 2011;77:524-531