Hiroki Nariai1, Shaun A Hussain2, Danilo Bernardo2, Aria Fallah3, Kristina K Murata2, Jimmy C Nguyen2, Rajsekar R Rajaraman2, Lekha M Rao2, Joyce H Matsumoto2, Jason T Lerner2, Noriko Salamon4, David Elashoff5, Raman Sankar2, Joyce Y Wu2. 1. Division of Pediatric Neurology, Department of Pediatrics, UCLA Mattel Children's Hospital, David Geffen School of Medicine, Los Angeles, CA, USA. Electronic address: hnariai@mednet.ucla.edu. 2. Division of Pediatric Neurology, Department of Pediatrics, UCLA Mattel Children's Hospital, David Geffen School of Medicine, Los Angeles, CA, USA. 3. Department of Neurosurgery, UCLA Medical Center, David Geffen School of Medicine, Los Angeles, CA, USA. 4. Division of Neuroradiology, Department of Radiology, UCLA Medical Center, David Geffen School of Medicine, Los Angeles, CA, USA. 5. Department of Medicine, Statistics Core, University of California, Los Angeles, CA, USA.
Abstract
OBJECTIVE: To investigate spatial correlation between interictal HFOs and neuroimaging abnormalities, and to determine if complete removal of prospectively identified interictal HFOs correlates with post-surgical seizure-freedom. METHODS: Interictal fast ripples (FRs: 250-500 Hz) in 19 consecutive children with pharmacoresistant focal epilepsy who underwent extra-operative electrocorticography (ECoG) recording were prospectively analyzed. The interictal FRs were sampled at 2000 Hz and were visually identified during 10 min of slow wave sleep. Interictal FRs, MRI and FDG-PET were delineated on patient-specific reconstructed three-dimensional brain MRI. RESULTS: Interictal FRs were observed in all patients except one. Thirteen out of 18 patients (72%) exhibited FRs beyond the extent of neuroimaging abnormalities. Fifteen of 19 children underwent resective surgery, and survival analysis with log-rank test demonstrated that complete resection of cortical sites showing interictal FRs correlated with longer post-operative seizure-freedom (p < 0.01). Complete resection of seizure onset zones (SOZ) also correlated with longer post-operative seizure-freedom (p = 0.01), yet complete resection of neuroimaging abnormalities did not (p = 0.43). CONCLUSIONS: Prospective visual analysis of interictal FRs was feasible, and it seemed to accurately localize epileptogenic zones. SIGNIFICANCE: Topological extent of epileptogenic region may exceed what is discernible by multimodal neuroimaging.
OBJECTIVE: To investigate spatial correlation between interictal HFOs and neuroimaging abnormalities, and to determine if complete removal of prospectively identified interictal HFOs correlates with post-surgical seizure-freedom. METHODS: Interictal fast ripples (FRs: 250-500 Hz) in 19 consecutive children with pharmacoresistant focal epilepsy who underwent extra-operative electrocorticography (ECoG) recording were prospectively analyzed. The interictal FRs were sampled at 2000 Hz and were visually identified during 10 min of slow wave sleep. Interictal FRs, MRI and FDG-PET were delineated on patient-specific reconstructed three-dimensional brain MRI. RESULTS: Interictal FRs were observed in all patients except one. Thirteen out of 18 patients (72%) exhibited FRs beyond the extent of neuroimaging abnormalities. Fifteen of 19 children underwent resective surgery, and survival analysis with log-rank test demonstrated that complete resection of cortical sites showing interictal FRs correlated with longer post-operative seizure-freedom (p < 0.01). Complete resection of seizure onset zones (SOZ) also correlated with longer post-operative seizure-freedom (p = 0.01), yet complete resection of neuroimaging abnormalities did not (p = 0.43). CONCLUSIONS: Prospective visual analysis of interictal FRs was feasible, and it seemed to accurately localize epileptogenic zones. SIGNIFICANCE: Topological extent of epileptogenic region may exceed what is discernible by multimodal neuroimaging.
Authors: Vasileios Dimakopoulos; Jean Gotman; William Stacey; Nicolás von Ellenrieder; Julia Jacobs; Christos Papadelis; Jan Cimbalnik; Gregory Worrell; Michael R Sperling; Maike Zijlmans; Lucas Imbach; Birgit Frauscher; Johannes Sarnthein Journal: Brain Commun Date: 2022-06-09
Authors: Jessica K Nadalin; Uri T Eden; Xue Han; R Mark Richardson; Catherine J Chu; Mark A Kramer Journal: J Neurosci Methods Date: 2021-06-04 Impact factor: 2.987