Spike ripples localize the epileptogenic zone best: an international intracranial study

Author:

Shi Wen12ORCID,Shaw Dana3,Walsh Katherine G12ORCID,Han Xue45ORCID,Eden Uri T46,Richardson Robert M27,Gliske Stephen V8ORCID,Jacobs Julia9101112,Brinkmann Benjamin H13ORCID,Worrell Gregory A13ORCID,Stacey William C14,Frauscher Birgit151617,Thomas John15,Kramer Mark A46ORCID,Chu Catherine J12ORCID

Affiliation:

1. Department of Neurology, Massachusetts General Hospital , Boston, MA 02114 , USA

2. Department of Neurology, Harvard Medical School , Boston, MA 02115 , USA

3. Graduate Program in Neuroscience, Boston University , Boston, MA 02215 , USA

4. Center for Systems Neuroscience, Boston University , Boston, MA 02215 , USA

5. Department of Biomedical Engineering, Boston University , Boston, MA 02215 , USA

6. Department of Mathematics and Statistics, Boston University , Boston, MA 02215 , USA

7. Department of Neurosurgery, Massachusetts General Hospital , Boston, MA 02114 , USA

8. Department of Neurosurgery, University of Nebraska Medical Center , Omaha, NE 68198 , USA

9. Department of Neuropediatrics and Muscle Disorders, Medical Center, University of Freiburg , Freiburg 79106 , Germany

10. Department of Paediatrics, Cumming School of Medicine, University of Calgary , Calgary, AB T2N 1N4 , Canada

11. Department of Neuroscience, Cumming School of Medicine, University of Calgary , Calgary, AB T2N 1N4 , Canada

12. Hotchkiss Brain Institute and Alberta Children’s Hospital Research Institute, University of Calgary , Calgary T2N 1N4, AB , Canada

13. Bioelectronics Neurophysiology and Engineering Lab, Mayo Clinic , Rochester, MN 55905 , USA

14. Department of Neurology, University of Michigan , Ann Arbor, MI 48109 , USA

15. Analytical Neurophysiology Lab, Montreal Neurological Institute and Hospital, McGill University , Montreal, QC H3A 0G4 , Canada

16. Analytical Neurophysiology Lab, Department of Neurology, Duke University Medical Center , Durham, NC 27710 , USA

17. Department of Biomedical Engineering, Duke Pratt School of Engineering , Durham, NC 27708 , USA

Abstract

Abstract We evaluated whether spike ripples, the combination of epileptiform spikes and ripples, provide a reliable and improved biomarker for the epileptogenic zone compared with other leading interictal biomarkers in a multicentre, international study. We first validated an automated spike ripple detector on intracranial EEG recordings. We then applied this detector to subjects from four centres who subsequently underwent surgical resection with known 1-year outcomes. We evaluated the spike ripple rate in subjects cured after resection [International League Against Epilepsy Class 1 outcome (ILAE 1)] and those with persistent seizures (ILAE 2–6) across sites and recording types. We also evaluated available interictal biomarkers: spike, spike-gamma, wideband high frequency oscillation (HFO, 80–500 Hz), ripple (80–250 Hz) and fast ripple (250–500 Hz) rates using previously validated automated detectors. The proportion of resected events was computed and compared across subject outcomes and biomarkers. Overall, 109 subjects were included. Most spike ripples were removed in subjects with ILAE 1 outcome (P < 0.001), and this was qualitatively observed across all sites and for depth and subdural electrodes (P < 0.001 and P < 0.001, respectively). Among ILAE 1 subjects, the mean spike ripple rate was higher in the resected volume (0.66/min) than in the non-removed tissue (0.08/min, P < 0.001). A higher proportion of spike ripples were removed in subjects with ILAE 1 outcomes compared with ILAE 2–6 outcomes (P = 0.06). Among ILAE 1 subjects, the proportion of spike ripples removed was higher than the proportion of spikes (P < 0.001), spike-gamma (P < 0.001), wideband HFOs (P < 0.001), ripples (P = 0.009) and fast ripples (P = 0.009) removed. At the individual level, more subjects with ILAE 1 outcomes had the majority of spike ripples removed (79%, 38/48) than spikes (69%, P = 0.12), spike-gamma (69%, P = 0.12), wideband HFOs (63%, P = 0.03), ripples (45%, P = 0.01) or fast ripples (36%, P < 0.001) removed. Thus, in this large, multicentre cohort, when surgical resection was successful, the majority of spike ripples were removed. Furthermore, automatically detected spike ripples localize the epileptogenic tissue better than spikes, spike-gamma, wideband HFOs, ripples and fast ripples.

Funder

National Institutes of Health

National Institute of Neurological Disease and Stroke

Publisher

Oxford University Press (OUP)

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3