From the Departments of Neurology (A.M.F., W.O.T.), Neurological Surgery (D.M., K.R., A.Q.-H.), Hematology/Oncology (S.S.R.), and Anesthesiology (P.S.B.), Mayo Clinic, Jacksonville, FL; and Departments of Neurology (G.A.W., B.H.B.) and Physiology and Biomedical Engineering (G.A.W., B.H.B.), Mayo Clinic, Rochester, MN.
Neurology. 2018 Mar 27;90(13):e1119-e1125. doi: 10.1212/WNL.0000000000005216. Epub 2018 Feb 28.
To examine the relationship between high-frequency oscillations (HFOs) and the presence of preoperative seizures, World Health Organization tumor grade, and isocitrate dehydrogenase 1 (IDH1) mutational status in gliomas.
We retrospectively studied intraoperative electrocorticography recorded in 16 patients with brain tumor (12 presenting with seizures) who underwent awake craniotomy and surgical resection between September 2016 and June 2017. The number and distribution of HFOs were determined and quantified visually and with an automated HFO detector.
Five patients had low-grade (1 with grade I and 4 with grade II) and 11 had high-grade (6 with grade III and 5 with grade IV) brain tumors. An IDH1 mutation was found in 6 patients. Patients with a history of preoperative seizures were more likely to have HFOs than those without preoperative seizures (9 of 12 vs 0 of 4, = 0.02). The rate of HFOs was higher in patients with IDH1 mutant (mean 7.2 per minute) than IDH wild-type (mean 2.3 per minute) genotype ( = 0.03).
HFOs are common in brain tumor-related epilepsy, and HFO rate may be a useful measure of epileptogenicity in gliomas. Our findings further support the notion that IDH1 mutant genotype is more epileptogenic than IDH1 wild-type genotype gliomas.
探讨高频振荡（HFOs）与术前癫痫、世界卫生组织肿瘤分级和异柠檬酸脱氢酶 1（IDH1）突变状态在脑肿瘤中的关系。
我们回顾性研究了 2016 年 9 月至 2017 年 6 月期间接受清醒开颅术和手术切除的 16 例脑肿瘤患者（12 例有癫痫发作）的术中皮质脑电图记录。通过视觉和自动 HFO 探测器确定和量化 HFO 的数量和分布。
5 例为低级别（1 级和 4 级），11 例为高级别（6 级和 5 级）脑肿瘤。6 例患者存在 IDH1 突变。有术前癫痫发作史的患者比无术前癫痫发作史的患者更有可能出现 HFO（12 例中有 9 例，4 例中无 0 例， = 0.02）。IDH1 突变型（平均每分钟 7.2 次）患者的 HFO 发生率高于 IDH1 野生型（平均每分钟 2.3 次）基因型（ = 0.03）。
HFOs 在与脑肿瘤相关的癫痫中很常见，HFO 率可能是评估胶质瘤致痫性的有用指标。我们的发现进一步支持 IDH1 突变型基因型比 IDH1 野生型基因型胶质瘤更具致痫性的观点。
