Feinberg School of Medicine, Northwestern University, Chicago, Illinois, U.S.A.
Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, U.S.A.
J Clin Neurophysiol. 2023 Nov 1;40(7):567-573. doi: 10.1097/WNP.0000000000000930. Epub 2022 Mar 25.
To define the patient characteristics, tumor characteristics, and clinical course of patients with primary brain tumors with high-frequency oscillations (HFOs) recorded on electrocorticography. Furthermore, we evaluated whether the presence of HFOs portends a greater risk of postoperative tumor-related epilepsy and whether the resection of HFO-generating tissue reduces likelihood of postoperative tumor-related epilepsy.
This was a retrospective study of 35 patients undergoing awake craniotomy for tumor resection, all of whom underwent intraoperative electrocorticography. Electrocorticography data were reviewed to assess the presence of HFOs and determine their contact locations. The data were analyzed to determine whether HFO-generating tissue was included in the resection and relationship to postoperative seizure outcome.
Seventeen patients (48.5%) were found to have HFOs. Very few patients (4 of 35, 11.4%) had sharp waves. Patients with and without HFOs did not significantly differ in demographics, presentation, tumor characteristics, or tumor molecular genetics. A history of seizures prior to resection was not associated with the presence of HFOs ( P = 0.62), although when patients had seizures during the same hospitalization as the resection, HFOs were more likely to be present ( P = 0.045). Extent of HFO resection was not associated with the likelihood of postoperative seizure freedom.
Approximately half (48.5%) of patients undergoing resection for a primary brain tumor had HFOs. Although HFO resection was not shown to lead to improved seizure freedom, this study was limited by a small sample size, and further investigation into HFO resection and patient outcomes in this population is warranted.
定义在皮层脑电图上记录到高频振荡（HFOs）的原发性脑肿瘤患者的患者特征、肿瘤特征和临床病程。此外，我们评估了 HFOs 的存在是否预示着术后肿瘤相关癫痫的风险增加，以及 HFO 产生组织的切除是否降低术后肿瘤相关癫痫的可能性。
这是一项对 35 例接受清醒开颅肿瘤切除术的患者进行的回顾性研究，所有患者均接受术中皮层脑电图检查。对皮层脑电图数据进行了回顾性评估，以评估 HFO 的存在并确定其接触位置。对数据进行了分析，以确定 HFO 产生的组织是否包含在切除范围内，以及与术后癫痫发作结果的关系。
发现 17 例（48.5%）患者存在 HFOs。极少数患者（35 例中有 4 例，11.4%）存在尖波。有无 HFOs 的患者在人口统计学、表现、肿瘤特征或肿瘤分子遗传学方面没有显著差异。术前有癫痫发作史与 HFOs 的存在无关（P=0.62），尽管当患者在与切除术同一住院期间发生癫痫时，更有可能存在 HFOs（P=0.045）。HFO 切除的范围与术后无癫痫发作的可能性无关。
大约一半（48.5%）接受原发性脑肿瘤切除术的患者存在 HFOs。尽管 HFO 切除并未显示出改善癫痫无发作的效果，但本研究受到样本量小的限制，需要进一步研究该人群中 HFO 切除和患者结局。
