Ictal high-gamma oscillation (60-99 Hz) in intracranial electroencephalography and postoperative seizure outcome in neocortical epilepsy.

OBJECTIVE

High-gamma oscillations (HGOs) (60-99 Hz) have been suggested to correlate with seizure onset zones and seizure outcomes. We investigated the correlation between the extent of removal of ictal HGO generating areas and postoperative seizure outcome in neocortical epilepsy (NE).

METHODS

Twenty three patients with medically intractable NE underwent chronic intracranial electroencephalography (iEEG) using subdural electrodes. Ictal HGOs and superimposed undersampled ripples within ±3 s of video-iEEG ictal onset were extracted by wavelet clustering and thresholding. Cluster epileptogenicity indices (CEIs) were calculated. The temporal analysis window was locked to the timing of the maximum CEI wavecluster. Root mean square amplitudes, cross-correlation synchronies and the local focus indices within the temporal window were calculated.

RESULTS

Percentages of resected maximum CEI waveclusters and HGO zones with high standardised amplitudes (>3), high cross-correlation synchronies (>0.9) and high local focus indices (>2) were significantly higher in the seizure-free group compared to the not seizure-free group (p=0.036, p=0.018, and p=0.026, respectively).

CONCLUSIONS

The automatic quantitative ictal HGO analysis may be effective in delineating the epileptogenic zone.

SIGNIFICANCE

HGO analysis may be helpful for improving post-resection seizure outcome in NE in the future.