Xiang Jing, Maue Ellen, Tong Han, Mangano Francesco T, Greiner Hansel, Tenney Jeffrey
MEG Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.
MEG Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.
Seizure. 2021 Jul;89:30-37. doi: 10.1016/j.seizure.2021.04.024. Epub 2021 May 4.
OBJECTIVE: One barrier hindering high frequency brain signals (HFBS, >80 Hz) from wide clinical applications is that the brain generates both pathological and physiological HFBS. This study was to find specific biomarkers for localizing epileptogenic zones (EZs). METHODS: Twenty three children with drug-resistant epilepsy and age/sex matched healthy controls were studied with magnetoencephalography (MEG). High frequency oscillations (HFOs, > 4 oscillatory waveforms) and high frequency spikes (HFSs, > 1 spiky or sharp waveforms) in 80-250 Hz and 250-600 Hz bands were blindly detected with an artificial intelligence method and validated with visual inspection. The magnitude of HFOs and HFSs were quantified with spectral analyses. Sources of HFSs and HFOs were localized and compared with clinical EZs determined by invasive recordings and surgical outcomes. RESULTS: HFOs in 80-250 Hz and 250-600 Hz were identified in both epilepsy patients (18/23, 12/23, respectively) and healthy controls (6/23, 4/23, respectively). HFSs in 80-250 Hz and 250-600 Hz were detected in patients (16/23, 11/23, respectively) but not in healthy controls. A combination of HFOs and HFSs localized EZs for 22 (22/23, 96%) patients. CONCLUSIONS: The results indicate, for the first time, that HFSs are a newer and more specific biomarker than HFOs for localizing EZs because HFOs appeared in both epilepsy patients and healthy controls while HFSs appeared only in epilepsy patients.
目的:阻碍高频脑信号(HFBS,>80Hz)广泛临床应用的一个障碍是大脑会产生病理性和生理性的高频脑信号。本研究旨在寻找用于定位致痫区(EZs)的特定生物标志物。 方法:对23例耐药性癫痫儿童及年龄/性别匹配的健康对照者进行了脑磁图(MEG)研究。采用人工智能方法盲目检测80 - 250Hz和250 - 600Hz频段的高频振荡(HFOs,>4个振荡波形)和高频棘波(HFSs,>1个尖峰或尖锐波形),并通过视觉检查进行验证。通过频谱分析对HFOs和HFSs的幅度进行量化。对HFSs和HFOs的来源进行定位,并与通过侵入性记录和手术结果确定的临床致痫区进行比较。 结果:癫痫患者(分别为18/23、12/23)和健康对照者(分别为6/23、4/23)均检测到80 - 250Hz和250 - 600Hz的HFOs。患者(分别为16/23、11/23)检测到80 - 250Hz和250 - 600Hz的HFSs,而健康对照者未检测到。HFOs和HFSs的组合为22例(22/23,96%)患者定位了致痫区。 结论:结果首次表明,对于定位致痫区而言,HFSs是一种比HFOs更新且更特异的生物标志物,因为HFOs在癫痫患者和健康对照者中均出现,而HFSs仅在癫痫患者中出现。
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