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High frequency oscillations relate to cognitive improvement after epilepsy surgery in children |
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| Institution: | 1. Epilepsy Unit, Neurology Department, Vall d''Hebron University Hospital, Autonomous University of Barcelona, Barcelona, Spain;2. School of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain;1. Department of Neurology, Baylor College of Medicine, Houston, TX, USA;2. Neurology Care Line, Michael E DeBakey VA Medical Center, Houston, TX, USA;3. Department of Statistics, Rice University, Houston, TX, USA;4. Department of Neurology, University of California, Los Angeles, CA, USA;5. Department of Neurobiology, Department of Psychiatry and Biobehavioral Sciences, and the Brain Research Institute, University of California, Los Angeles, CA, USA;1. Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Australia;2. Department of Clinical Neuropsychology, Austin Health, Melbourne, Australia |
| Abstract: | ObjectiveTo investigate how high frequency oscillations (HFOs; ripples 80–250 Hz, fast ripples (FRs) 250–500 Hz) and spikes in intra-operative electrocorticography (ioECoG) relate to cognitive outcome after epilepsy surgery in children.MethodsWe retrospectively included 20 children who were seizure free after epilepsy surgery using ioECoG and determined their intelligence quotients (IQ) pre- and two years postoperatively. We analyzed whether the number of HFOs and spikes in pre- and postresection ioECoGs, and their change in the non-resected areas relate to cognitive improvement (with ≥ 5 IQ points increase considered to be clinically relevant (=IQ+ group) and < 5 IQ points as irrelevant (=IQ? group)).ResultsThe IQ+ group showed significantly more FRs in the resected tissue (p = 0.01) and less FRs in the postresection ioECoG (p = 0.045) compared to the IQ? group. Postresection decrease of ripples on spikes was correlated with postoperative cognitive improvement (correlation coefficient = ?0.62 with p = 0.01).ConclusionsPostoperative cognitive improvement was related to reduction of pathological HFOs signified by removing FR generating areas with subsequently less residual FRs, and decrease of ripples on spikes in the resection edge of the non-resected area.SignificanceHFOs recorded in ioECoG could play a role as biomarkers in the prediction and understanding of cognitive outcome after epilepsy surgery. |
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