van Klink N E C, Van't Klooster M A, Zelmann R, Leijten F S S, Ferrier C H, Braun K P J, van Rijen P C, van Putten M J A M, Huiskamp G J M, Zijlmans M
Brain Center Rudolf Magnus, Department of Neurology and Neurosurgery, University Medical Center Utrecht, The Netherlands; MIRA, Institute for Technical Medicine, University of Twente, The Netherlands.
Brain Center Rudolf Magnus, Department of Neurology and Neurosurgery, University Medical Center Utrecht, The Netherlands.
Clin Neurophysiol. 2014 Nov;125(11):2212-2219. doi: 10.1016/j.clinph.2014.03.004. Epub 2014 Mar 13.
Removal of brain tissue showing high frequency oscillations (HFOs; ripples: 80-250Hz and fast ripples: 250-500Hz) in preresection electrocorticography (preECoG) in epilepsy patients seems a predictor of good surgical outcome. We analyzed occurrence and localization of HFOs in intra-operative preECoG and postresection electrocorticography (postECoG).
HFOs were automatically detected in one-minute epochs of intra-operative ECoG sampled at 2048Hz of fourteen patients. Ripple, fast ripple, spike, ripples on a spike (RoS) and not on a spike (RnoS) rates were analyzed in pre- and postECoG for resected and nonresected electrodes.
Ripple, spike and fast ripple rates decreased after resection. RnoS decreased less than RoS (74% vs. 83%; p=0.01). Most fast ripples in preECoG were located in resected tissue. PostECoG fast ripples occurred in one patient with poor outcome. Patients with good outcome had relatively high postECoG RnoS rates, specifically in the sensorimotor cortex.
Our observations show that fast ripples in intra-operative ECoG, compared to ripples, may be a better biomarker for epileptogenicity. Further studies have to determine the relation between resection of epileptogenic tissue and physiological ripples generated by the sensorimotor cortex.
Fast ripples in intra-operative ECoG can help identify the epileptogenic zone, while ripples might also be physiological.
在癫痫患者术前皮层脑电图（preECoG）中切除显示高频振荡（HFOs；涟漪：80 - 250Hz和快速涟漪：250 - 500Hz）的脑组织似乎是手术良好预后的一个预测指标。我们分析了术中preECoG和术后皮层脑电图（postECoG）中HFOs的发生情况和定位。
对14例患者在术中以2048Hz采样的1分钟皮层脑电图片段自动检测HFOs。分析了切除电极和未切除电极在preECoG和postECoG中的涟漪、快速涟漪、棘波、棘波上的涟漪（RoS）和非棘波上的涟漪（RnoS）发生率。
切除后涟漪、棘波和快速涟漪发生率下降。RnoS下降幅度小于RoS（74%对83%；p = 0.01）。preECoG中的大多数快速涟漪位于切除组织中。postECoG快速涟漪出现在1例预后不良的患者中。预后良好的患者postECoG的RnoS发生率相对较高，特别是在感觉运动皮层。
我们的观察表明，与涟漪相比，术中皮层脑电图中的快速涟漪可能是更好的癫痫源性生物标志物。进一步的研究必须确定癫痫源组织切除与感觉运动皮层产生的生理性涟漪之间的关系。
术中皮层脑电图中的快速涟漪有助于识别癫痫源区，而涟漪也可能是生理性的。
