Occurrence of scalp-fast oscillations among patients with different spiking rate and their role as epileptogenicity marker
Occurrence of scalp-fast oscillations among patients with different spiking rate and their role as epileptogenicity marker
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DOI：
10.1016/j.eplepsyres.2013.06.003
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发表时间：
2013-10-01
影响因子：
2.2
通讯作者：
Gotman, Jean
中科院分区：
文献类型：
--
作者：
Melani, Federico;Zelmann, Rina;Gotman, Jean
前言：我们旨在分析低至高间期癫痫样放电（IEDs）发生率局灶性癫痫患者的头皮脑电图快速振荡，以确定这种神经生理特征如何影响快速振荡的发生及其作为癫痫发作区（SOZ）标志的意义。方法：对32例患者进行研究，根据发生IED的频率将其分为4类：A、B、C组分别为高、中、低IED发生率，D组为无IED发生率。对300 Hz低通滤波和1000 Hz采样的30分钟慢波睡眠脑电图进行了回顾。ied和快速振荡（伽马活动，40-80赫兹；涟漪，bbb -80赫兹）是明显的。每个通道被划分为刺激区和SOZ内外。我们计算了ied和快速振荡的数量和发生率，它们在刺激区和SOZ的共现率，它们在刺激区和SOZ的频率，以及确定SOZ的特异性，敏感性和准确性，以确定总体和每组SOZ。结果：共分析984个通道。A组（高IED率）振荡速率最高（gamma: 0.37 +/- 0.73，波纹：0.17 +/- 0.26），其次是B组（gamma: 0.08 +/- 0.06，波纹：0.07 +/- 0.05），C组（gamma: 0.06 +/- 0.06，波纹：0.04 +/- 0.01），最后是D组，振荡速率极低（gamma: 0.03 +/- 0，波纹：0.03 +/- 0）。与伽马射线同时发生的ied占9.5%，涟漪占3.2%；伽马和波纹与ied同时发生的比例分别为46.2%和44.4%。刺激区内快速振荡频率高于刺激区外（p < 0.001）。与ied相比，快速振荡识别SOZ的灵敏度较低（灵敏度：ied 78%， gamma 66%，波纹48%），但特异性更高（特异性：ied 50%， gamma 76%，波纹83%），准确性更高（准确性：ied 54%， gamma 74%，波纹77%）；不同的组分别得到了相同的结果。结论：本研究证实了快速振荡可以从头皮脑电图记录。伽马活动和波纹在频繁发生ied的患者中更为频繁，通常在刺激区内。然而，与ied相比，伽马和波纹在识别SOZ方面不太敏感，但更具体和准确，并且在低快速振荡率的患者中仍然如此。这些发现表明，ied和快速振荡可能共享一些共同的神经网络，但伽马活动和涟漪是更好的癫痫性生物标志物(C) 2013 Elsevier B.V.。
Introduction: We aim to analyze the fast oscillations in the scalp EEG of focal epilepsy patients with low-to-high rates of interictal epileptiform discharges (IEDs), in order to determine how this neurophysiological feature influences fast oscillation occurrence and their significance as markers of the seizure onset zone (SOZ).Methods: Thirty-two patients were studied, subdivided in four categories based on IED frequency: groups A, B and C respectively with high, intermediate and low IED rate, and group D with no IED. Thirty minutes of slow-wave sleep EEG, low-pass filtered at 300 Hz and sampled at 1000 Hz, were reviewed. IEDs and fast oscillations (gamma activity, 40-80 Hz; and ripples, >80 Hz) were marked. Each channel was classified as inside or outside the irritative zone and the SOZ. We calculated the number and rates of IEDs and fast oscillation, their co-occurrence, their frequency in the irritative zone and SOZ, and the specificity, sensitivity and accuracy to determine the SOZ in the overall population and separately for each group.Results: We analyzed 984 channels. Group A (high IED rate) showed the highest fast oscillation rate (gamma: 0.37 +/- 0.73; ripples: 0.17 +/- 0.26), followed by group B (gamma: 0.08 +/- 0.06; ripples: 0.07 +/- 0.05), group C (gamma: 0.06 +/- 0.06; ripples: 0.04 +/- 0.01), and finally group D, with very low values (gamma: 0.03 +/- 0; ripples: 0.03 +/- 0). IEDs co-occurred with gamma in 9.5% and with ripples in 3.2%; and gamma and ripples co-occurred with IEDs in 46.2% and 44.4%, respectively. The fast oscillations were more frequent inside than outside the irritative zone and the SOZ (p < 0.001). Compared to the IEDs, the fast oscillations were less sensitive (sensitivity: IEDs 78%, gamma 66% and ripples 48%) but more specific (specificity: IEDs 50%, gamma 76% and ripples 83%) and accurate (accuracy: IEDs 54%, gamma 74% and ripples 77%) in identifying the SOZ; the same results were reproduced for the different groups separately.Conclusions: This study confirms that fast oscillations can be recorded from the scalp EEG. Gamma activity and ripples are more frequent in patients with frequent IEDs and, in general, inside the irritative zone. However, compared to IEDs, gamma and ripples are less sensitive but more specific and accurate in identifying the SOZ, and this remains in patients with low fast oscillation rates. These findings suggest that IEDs and fast oscillations could share some common neuronal network, but gamma activity and ripples are a better biomarker of epileptogenicity (C) 2013 Elsevier B.V. All rights reserved.