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Simultaneously recorded intracranial and scalp high frequency oscillations help identify patients with poor postsurgical seizure outcome
Institution:1. Department of Neurosurgery, Hospital Universitario de Canarias, S/C de Tenerife, Spain;2. Intraoperative Neurophysiologic Monitoring Unit, Hospital Universitario de Canarias, S/C de Tenerife, Spain;1. Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, University College London, London, United Kingdom;2. Epilepsy Society MRI Unit, Chalfont St. Peter, United Kingdom;3. Wellcome/EPSRC Centre Interventional and Surgical Sciences, University College London, London, United Kingdom;4. Translational Imaging Group, Centre for Medical Image Computing, University College London, London, United Kingdom;5. National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom;6. School of Biomedical Engineering and Imaging Sciences, St Thomas’ Hospital, King’s College London, London, United Kingdom;1. Department of Pharmacology, JIPMER Karaikal, Puducherry, India;2. Department of Pharmacology, AIIMS Raipur, Chhattisgarh, India;3. Department of Biochemistry, JIPMER Karaikal, Puducherry, India;4. Department of Microbiology, AIIMS Raipur, Chhattisgarh, India;1. Laboratory of Children’s Brain Dynamics, Division of Newborn Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA;2. Fetal-Neonatal Neuroimaging Developmental Science Center, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA;3. Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA;4. Sapporo Neuroimaging Research Group, Sapporo, Japan;5. Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children''s Hospital, Harvard Medical School, Boston, MA, USA;6. Division of Epilepsy Surgery, Department of Neurosurgery, Boston Children''s Hospital, Harvard Medical School, USA;1. Functional Brain Mapping Lab, Faculty of Medicine, University of Geneva, Switzerland;2. EEG and Epilepsy Unit, Neurology Clinic, University Hospital and Faculty of Medicine of Geneva, Switzerland;3. Nuclear Medicine, Department of Radiology, University Hospital and Faculty of Medicine of Geneva, Switzerland;4. Pediatric Neurology, Child and Adolescent Department, University Hospital and Faculty of Medicine of Geneva, Switzerland;5. Department of Neurosurgery, University Hospital and Faculty of Medicine of Geneva, Switzerland
Abstract:ObjectiveHigh frequency oscillations (HFO) between 80–500 Hz are markers of epileptic areas in intracranial and maybe also scalp EEG. We investigate simultaneous recordings of scalp and intracranial EEG and hypothesize that scalp HFOs provide important additional clinical information in the presurgical setting.MethodsSpikes and HFOs were visually identified in all intracranial scalp EEG channels. Analysis of correlation of event location between intracranial and scalp EEG as well as relationship between events and the SOZ and zone of surgical removal was performed.Results24 patients could be included, 23 showed spikes and 19 HFOs on scalp recordings. In 15/19 patients highest scalp HFO rate was located over the implantation side, with 13 patients having the highest scalp and intracranial HFO rate over the same region. 17 patients underwent surgery, 7 became seizure free. Patients with poor post-operative outcome showed significantly more regions with HFO than those with seizure free outcome.ConclusionsScalp HFOs are mostly located over the SOZ. Widespread scalp HFOs are indicative of a larger epileptic network and associated with poor postsurgical outcome.SignificanceAnalysis of scalp HFO add clinically important information about the extent of epileptic areas during presurgical simultaneous scalp and intracranial EEG recordings.
Keywords:Refractory epilepsy  High frequency oscillations  Epilepsy surgery  Spikes  Seizure onset  EEG"}  {"#name":"keyword"  "$":{"id":"k0035"}  "$$":[{"#name":"text"  "_":"electro-enzephalography  FCD"}  {"#name":"keyword"  "$":{"id":"k0045"}  "$$":[{"#name":"text"  "_":"focal cortical dysplasia  HFO"}  {"#name":"keyword"  "$":{"id":"k0055"}  "$$":[{"#name":"text"  "_":"high frequency oscillation  MRT"}  {"#name":"keyword"  "$":{"id":"k0065"}  "$$":[{"#name":"text"  "_":"magnet resonance tomography  SOZ"}  {"#name":"keyword"  "$":{"id":"k0075"}  "$$":[{"#name":"text"  "_":"seizure onset zone
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