OBJECTIVE: Intraoperative electrocorticography (ECoG) can be used to delineate the resection area in epilepsy surgery. High-frequency oscillations (HFOs; 80-500 Hz) seem better biomarkers for epileptogenic tissue than spikes. We studied how HFOs and spikes in combined pre- and postresection ECoG predict surgical outcome in different tailoring approaches. METHODS: We, retrospectively, marked HFOs, divided into fast ripples (FRs; 250-500 Hz) and ripples (80-250 Hz), and spikes in pre- and postresection ECoG sampled at 2,048 Hz in people with refractory focal epilepsy. We defined four groups of electroencephalography (EEG) event occurrence: pre+post- (+/-), pre+post+ (+/+), pre-post+ (-/+) and pre-post- (-/-). We subcategorized three tailoring approaches: hippocampectomy with tailoring for neocortical involvement; lesionectomy of temporal lesions with tailoring for mesiotemporal involvement; and lesionectomy with tailoring for surrounding neocortical involvement. We compared the percentage of resected pre-EEG events, time to recurrence, and the different tailoring approaches to outcome (seizure-free vs recurrence). RESULTS: We included 54 patients (median age, 15.5 years; 25 months of follow-up; 30 seizure free). The percentage of resected FRs, ripples, or spikes in pre-ECoG did not predict outcome. The occurrence of FRs in post-ECoG, given FRs in pre-ECoG (+/-, +/+), predicted outcome (hazard ratio, 3.13; confidence interval = 1.22-6.25; p = 0.01). Seven of 8 patients without spikes in pre-ECoG were seizure free. The highest predictive value for seizure recurrence was presence of FRs in post-ECoG for all tailoring approaches. INTERPRETATION: FRs that persist before and after resection predict poor postsurgical outcome. These findings hold for different tailoring approaches. FRs can thus be used for tailoring epilepsy surgery with repeated intraoperative ECoG measurements. Ann Neurol 2017;81:664-676.
OBJECTIVE: Intraoperative electrocorticography (ECoG) can be used to delineate the resection area in epilepsy surgery. High-frequency oscillations (HFOs; 80-500 Hz) seem better biomarkers for epileptogenic tissue than spikes. We studied how HFOs and spikes in combined pre- and postresection ECoG predict surgical outcome in different tailoring approaches. METHODS: We, retrospectively, marked HFOs, divided into fast ripples (FRs; 250-500 Hz) and ripples (80-250 Hz), and spikes in pre- and postresection ECoG sampled at 2,048 Hz in people with refractory focal epilepsy. We defined four groups of electroencephalography (EEG) event occurrence: pre+post- (+/-), pre+post+ (+/+), pre-post+ (-/+) and pre-post- (-/-). We subcategorized three tailoring approaches: hippocampectomy with tailoring for neocortical involvement; lesionectomy of temporal lesions with tailoring for mesiotemporal involvement; and lesionectomy with tailoring for surrounding neocortical involvement. We compared the percentage of resected pre-EEG events, time to recurrence, and the different tailoring approaches to outcome (seizure-free vs recurrence). RESULTS: We included 54 patients (median age, 15.5 years; 25 months of follow-up; 30 seizure free). The percentage of resected FRs, ripples, or spikes in pre-ECoG did not predict outcome. The occurrence of FRs in post-ECoG, given FRs in pre-ECoG (+/-, +/+), predicted outcome (hazard ratio, 3.13; confidence interval = 1.22-6.25; p = 0.01). Seven of 8 patients without spikes in pre-ECoG were seizure free. The highest predictive value for seizure recurrence was presence of FRs in post-ECoG for all tailoring approaches. INTERPRETATION: FRs that persist before and after resection predict poor postsurgical outcome. These findings hold for different tailoring approaches. FRs can thus be used for tailoring epilepsy surgery with repeated intraoperative ECoG measurements. Ann Neurol 2017;81:664-676.
Authors: Somin Lee; Naoum P Issa; Sandra Rose; James X Tao; Peter C Warnke; Vernon L Towle; Wim van Drongelen; Shasha Wu Journal: Seizure Date: 2019-05-03 Impact factor: 3.184
Authors: Shennan A Weiss; Zachary Waldman; Federico Raimondo; Diego Slezak; Mustafa Donmez; Gregory Worrell; Anatol Bragin; Jerome Engel; Richard Staba; Michael Sperling Journal: Biomark Med Date: 2019-05-02 Impact factor: 2.851
Authors: Birgit Frauscher; Fabrice Bartolomei; Katsuhiro Kobayashi; Jan Cimbalnik; Maryse A van 't Klooster; Stefan Rampp; Hiroshi Otsubo; Yvonne Höller; Joyce Y Wu; Eishi Asano; Jerome Engel; Philippe Kahane; Julia Jacobs; Jean Gotman Journal: Epilepsia Date: 2017-06-30 Impact factor: 5.864
Authors: Pariya Salami; Noam Peled; Jessica K Nadalin; Louis-Emmanuel Martinet; Mark A Kramer; Jong W Lee; Sydney S Cash Journal: Clin Neurophysiol Date: 2020-05-29 Impact factor: 3.708
Authors: Carlos Cepeda; Simon Levinson; Hiroki Nariai; Vannah-Wila Yazon; Conny Tran; Joshua Barry; Katerina D Oikonomou; Harry V Vinters; Aria Fallah; Gary W Mathern; Joyce Y Wu Journal: Neurobiol Dis Date: 2019-10-17 Impact factor: 5.996
Authors: Julia Jacobs; Joyce Y Wu; Piero Perucca; Rina Zelmann; Malenka Mader; Francois Dubeau; Gary W Mathern; Andreas Schulze-Bonhage; Jean Gotman Journal: Neurology Date: 2018-08-17 Impact factor: 9.910