Removing high-frequency oscillations: A prospective multicenter study on seizure outcome
Julia Jacobs,Joyce Y. Wu,Piero Perucca,Rina Zelmann,Malenka Mader,F. Dubeau,Gary W. Mathern,Andreas Schulze-Bonhage,Jean Gotman +8 more
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TLDR
Evaluating the use of interictal high-frequency oscillations in epilepsy surgery for prediction of postsurgical seizure outcome in a prospective multicenter trial found HFOs may be less specific for epileptic tissue than earlier studies have indicated.Abstract:
Objective To evaluate the use of interictal high-frequency oscillations (HFOs) in epilepsy surgery for prediction of postsurgical seizure outcome in a prospective multicenter trial. Methods We hypothesized that a seizure-free outcome could be expected in patients in whom the surgical planning included the majority of HFO-generating brain tissue while a poor seizure outcome could be expected in patients in whom only a few such areas were planned to be resected. Fifty-two patients were included from 3 tertiary epilepsy centers during a 1-year period. Ripples (80–250 Hz) and fast ripples (250–500 Hz) were automatically detected during slow-wave sleep with chronic intracranial EEG in 2 centers and acute intraoperative electrocorticography in 1 patient. Results There was a correlation between the removal of HFO-generating regions and seizure-free outcome at the group level for all patients. No correlation was found, however, for the center-specific analysis, and an individual prognostication of seizure outcome was true in only 36 patients (67%). Moreover, some patients became seizure-free without removal of the majority of HFO-generating tissue. The investigation of influencing factors, including comparisons of visual and automatic analysis, using a threshold analysis for areas with high HFO activity, and excluding contacts bordering the resection, did not result in improved prognostication. Conclusions On an individual patient level, a prediction of outcome was not possible in all patients. This may be due to the analysis techniques used. Alternatively, HFOs may be less specific for epileptic tissue than earlier studies have indicated.read more
Citations
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Journal ArticleDOI
Changing concepts in presurgical assessment for epilepsy surgery
TL;DR: The importance of looking beyond the EEG seizure onset zone and considering focal epilepsy as a brain network disease in which long-range connections need to be taken into account is highlighted, and how new diagnostic techniques are revealing essential information in the brain that was previously hidden from view is explored.
Journal ArticleDOI
Localization of the Epileptogenic Zone Using High Frequency Oscillations
TL;DR: High-frequency oscillations are suggested to be a promising biomarker of the EZ, with a potential to improve surgical success in patients with drug-resistant epilepsy without the need to record seizures, but in order to establish HFOs as a clinical biomarker, the following issues need to be addressed.
Journal ArticleDOI
High-Frequency Oscillation Networks and Surgical Outcome in Adult Focal Epilepsy.
Karina A. González Otárula,Karina A. González Otárula,Nicolás von Ellenrieder,Carolina Cuello-Oderiz,François Dubeau,Jean Gotman +5 more
TL;DR: Whether high‐frequency oscillations show spatiotemporal propagation and the relevance of the earliest oscillations in relation to the seizure onset zone (SOZ) and postsurgical outcome are investigated.
Journal ArticleDOI
Intracranial EEG in the 21st Century
Barbara C. Jobst,Fabrice Bartolomei,Beate Diehl,Birgit Frauscher,Philippe Kahane,Lorella Minotti,Ashwini Sharan,Nastasia Tardy,Gregory A. Worrell,Jean Gotman +9 more
TL;DR: Improved techniques to record and interpret iEEG may in the future lead to a greater proportion of patients being seizure free after epilepsy surgery, and advanced computational methods such as determining the epileptogenicity index and similar measures may enhance standard clinical interpretation.
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Impact of predictive, preventive and precision medicine strategies in epilepsy.
TL;DR: The authors discuss the ongoing shift towards personalized treatments for specific epilepsy aetiologies, which has led to the development of diagnostic biomarkers for epilepsy and the redefinition of some epileptic syndromes to incorporate aetiology.
References
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Journal ArticleDOI
Presurgical evaluation of epilepsy.
Felix Rosenow,Hans Lüders +1 more
TL;DR: The current diagnostic techniques used in the definition of these cortical zones, such as video-EEG monitoring, MRI and ictal single photon emission computed tomography, are discussed and possible future developments that might lead to a more direct definition of the epileptogenic zone are presented.
Journal ArticleDOI
High-frequency electroencephalographic oscillations correlate with outcome of epilepsy surgery.
Julia Jacobs,Maeike Zijlmans,Rina Zelmann,Claude-Édouard Chatillon,Jeffrey Hall,André Olivier,François Dubeau,Jean Gotman +7 more
TL;DR: This work investigated whether HFOs can delineate epileptogenic areas even outside the SOZ by correlating the resection of HFO‐generating areas with surgical outcome.
Journal ArticleDOI
Interictal high-frequency oscillations (80–500 Hz) are an indicator of seizure onset areas independent of spikes in the human epileptic brain
TL;DR: High‐frequency oscillations known as ripples and fast ripples can be recorded from macroelectrodes inserted in patients with intractable focal epilepsy and are most likely linked to epileptogenesis.
Journal ArticleDOI
High-frequency oscillations : What is normal and what is not?
TL;DR: Investigation into the fundamental neuronal processes responsible for pHFOs could provide insights into basic mechanisms of epilepsy, and the potential for pH FOs to act as biomarkers for epileptogenesis and epileptogenicity is also discussed.
Journal ArticleDOI
High-frequency oscillations in human temporal lobe : simultaneous microwire and clinical macroelectrode recordings
Greg Worrell,Andrew B. Gardner,S. Matt Stead,Sanqing Hu,Steve Goerss,Gregory J. Cascino,Fredric B. Meyer,Richard W. Marsh,Brian Litt +8 more
TL;DR: R ripple and fast-ripple HFO recorded from both microwires and clinical macroelectrodes were increased in seizure generating brain regions compared to control regions, supporting the hypothesis that fast- Ripple HFO are primarily generated by highly localized, sub-millimeter scale neuronal assemblies that are most effectively sampled by microwire electrodes.