高密度 ECoG 提高了高频振荡的检测，高频振荡可以预测癫痫发作的结果。

High-density ECoG improves the detection of high frequency oscillations that predict seizure outcome.

机构信息

Klinik für Neurochirurgie, UniversitätsSpital und Universität Zürich, Switzerland.

Neuropädiatrie, Universitäts-Kinderspital Zürich, Switzerland.

出版信息

Clin Neurophysiol. 2019 Oct;130(10):1882-1888. doi: 10.1016/j.clinph.2019.07.008. Epub 2019 Jul 23.

DOI:10.1016/j.clinph.2019.07.008

PMID:31404865

Abstract

OBJECTIVES

Residual fast ripples (FR) in the intraoperative ECoG are highly specific predictors of postsurgical seizure recurrence. However, a FR is generated by a small patch of cortical tissue. Spatial sampling with standard electrodes may thus miss clinically relevant information.

METHODS

We analyzed FR rates in the intraoperative ECoG of 22 patients that underwent resective epilepsy surgery. We used standard electrodes with 10 mm inter-contact spacing (standard ECoG) in 14 surgeries and high-density grid electrodes with 5 mm spacing (hd-ECoG) in 8 surgeries. We detected FR using a previously validated automatic detector.

RESULTS

Postoperative seizure freedom was achieved in 14/22 (64%) cases. Across all 42 ECoG recordings, FR rates were higher for hd-ECoG than for standard ECoG. In the 14 seizure free patients (ILAE 1), no residual FR were detected (specificity = 100%). In the 8 patients with seizure recurrence (ILAE > 1), residual FR were detected in 1/7 standard ECoG and 1/1 hd-ECoG (Accuracy ACC = 57%, CI [29% 82%], ACC = 100%, CI [63% 100%]).

CONCLUSION

Denser spatial sampling by hd-ECoG improved FR detection compared to standard ECoG.

SIGNIFICANCE

Hd-ECoG may advance seizure freedom after epilepsy surgery.

摘要

目的

术中 ECoG 中的残留快棘波（FR）是术后癫痫发作复发的高度特异性预测指标。然而，一个 FR 是由一小片皮质组织产生的。因此，标准电极的空间采样可能会错过临床相关信息。

方法

我们分析了 22 名接受切除性癫痫手术的患者术中 ECoG 的 FR 率。我们在 14 例手术中使用了具有 10mm 接触间隔（标准 ECoG）的标准电极，在 8 例手术中使用了具有 5mm 间隔的高密度网格电极（hd-ECoG）。我们使用以前验证过的自动检测器检测 FR。

结果

22 例患者中有 14 例（64%）术后无癫痫发作。在所有 42 例 ECoG 记录中，hd-ECoG 的 FR 率高于标准 ECoG。在 14 例无癫痫发作的患者（ILAE 1）中，未检测到残留 FR（特异性=100%）。在 8 例癫痫发作复发的患者（ILAE >1）中，在 1/7 例标准 ECoG 和 1/1 例 hd-ECoG 中检测到残留 FR（准确性 ACC=57%，CI [29% 82%]，ACC=100%，CI [63% 100%]）。