High-frequency oscillations in scalp EEG mirror seizure frequency in pediatric focal epilepsy
High-frequency oscillations in scalp EEG mirror seizure frequency in pediatric focal epilepsy
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DOI：
10.1038/s41598-019-52700-w
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发表时间：
2019-11-12
影响因子：
4.6
通讯作者：
Fedele, Tommaso
中科院分区：
文献类型：
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作者：
Boran, Ece;Sarnthein, Johannes;Fedele, Tommaso
高频振荡（HFO）是一种有前途的脑电图致痫性生物标志物。虽然支持其重要性的证据主要来自侵入性记录，但最近的研究已将这些观察结果扩展到广泛使用的头皮EEG中记录的HFO。在这里，我们调查了耐药局灶性癫痫的头皮HFO是否与癫痫的严重程度相对应，以及它们如何受到手术治疗的影响。在11名接受癫痫手术的耐药局灶性癫痫患儿中，我们用定制的低噪声放大器（LNA）前瞻性记录了手术前后的头皮EEG。在其中4例患儿中，我们还记录了术中皮质电图（ECoG）。为了检测临床相关的HFO，我们应用了先前验证的自动检测器。头皮HFO率与癫痫发作频率呈显著正相关（R-2 = 0.80，p < 0.001）。总体而言，活动性癫痫患者的头皮HFO发生率较高（19次记录，p= 0.0066，PPV = 86%，NPV= 80%，准确度= 84%CI [62%-94%]），并在成功的癫痫手术后降低。头皮EEG中最高HFO率的位置与ECoG中最高HFO率的位置相匹配。这项研究是使用非侵入性记录的头皮HFO来监测癫痫患者疾病严重程度的第一步。
High-frequency oscillations (HFO) are promising EEG biomarkers of epileptogenicity. While the evidence supporting their significance derives mainly from invasive recordings, recent studies have extended these observations to HFO recorded in the widely accessible scalp EEG. Here, we investigated whether scalp HFO in drug-resistant focal epilepsy correspond to epilepsy severity and how they are affected by surgical therapy. In eleven children with drug-resistant focal epilepsy that underwent epilepsy surgery, we prospectively recorded pre- and postsurgical scalp EEG with a custom-made low-noise amplifier (LNA). In four of these children, we also recorded intraoperative electrocorticography (ECoG). To detect clinically relevant HFO, we applied a previously validated automated detector. Scalp HFO rates showed a significant positive correlation with seizure frequency (R-2 = 0.80, p < 0.001). Overall, scalp HFO rates were higher in patients with active epilepsy (19 recordings, p= 0.0066, PPV = 86%, NPV= 80%, accuracy = 84% CI [62%94%]) and decreased following successful epilepsy surgery. The location of the highest HFO rates in scalp EEG matched the location of the highest HFO rates in ECoG. This study is the first step towards using non-invasively recorded scalp HFO to monitor disease severity in patients affected by epilepsy.