Kathryn A Davis1, Seth P Devries2, Abba Krieger3, Temenuzhka Mihaylova4, Daniela Minecan4, Brian Litt5, Joost B Wagenaar6, William C Stacey7. 1. Department of Neurology, University of Pennsylvania, USA. Electronic address: Kathryn.Davis@uphs.upenn.edu. 2. Dept of Pediatric Neurology, Helen DeVos Children's Hospital, USA. 3. Dept of Statistics, The Wharton School of the University of Pennsylvania, USA. 4. Dept of Neurology, University of Michigan, USA. 5. Department of Neurology, University of Pennsylvania, USA. 6. Department of Neurology, University of Pennsylvania, USA; Blackfynn, Inc, USA. 7. Dept of Neurology, University of Michigan, USA; Dept of Biomedical Engineering, University of Michigan, USA.
Abstract
OBJECTIVE: Recent research suggests that high frequency intracranial EEG (iEEG) may improve localization of epileptic networks. This study aims to determine whether recording macroelectrode iEEG with higher sampling rates improves seizure localization in clinical practice. METHODS: 14 iEEG seizures from 10 patients recorded with >2000 Hz sampling rate were downsampled to four sampling rates: 100, 200, 500, 1000 Hz. In the 56 seizures, seizure onset time and location was marked by 5 independent, blinded EEG experts. RESULTS: When reading iEEG under clinical conditions, there was no consistent difference in time or localization of seizure onset or number of electrodes involved in the seizure onset zone with sampling rates varying from 100 to 1000 Hz. Stratification of patients by outcome did not improve with higher sampling rate. CONCLUSION: When utilizing standard clinical protocols, there was no benefit to acquiring iEEGs with sampling rate >100 Hz. Significant variability was noted in EEG marking both within and between individual expert EEG readers. SIGNIFICANCE: Although commercial equipment is capable of sampling much faster than 100 Hz, tools allowing visualization of subtle high frequency activity such as HFOs will be required to improve patient care. Quantitative methods may decrease reader variability, and potentially improve patient outcomes.
OBJECTIVE: Recent research suggests that high frequency intracranial EEG (iEEG) may improve localization of epileptic networks. This study aims to determine whether recording macroelectrode iEEG with higher sampling rates improves seizure localization in clinical practice. METHODS: 14 iEEG seizures from 10 patients recorded with >2000 Hz sampling rate were downsampled to four sampling rates: 100, 200, 500, 1000 Hz. In the 56 seizures, seizure onset time and location was marked by 5 independent, blinded EEG experts. RESULTS: When reading iEEG under clinical conditions, there was no consistent difference in time or localization of seizure onset or number of electrodes involved in the seizure onset zone with sampling rates varying from 100 to 1000 Hz. Stratification of patients by outcome did not improve with higher sampling rate. CONCLUSION: When utilizing standard clinical protocols, there was no benefit to acquiring iEEGs with sampling rate >100 Hz. Significant variability was noted in EEG marking both within and between individual expert EEG readers. SIGNIFICANCE: Although commercial equipment is capable of sampling much faster than 100 Hz, tools allowing visualization of subtle high frequency activity such as HFOs will be required to improve patient care. Quantitative methods may decrease reader variability, and potentially improve patient outcomes.
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