Maeda Keisuke, Hosoda Nami, Tsuboi Himari, Naito Honoka, Kudo Chiaki, Fukumoto Junichi, Fujita Shiho, Ichino Naohiro, Osakabe Keisuke, Sugimoto Keiko, Yamaguchi Shunta, Ishihara Naoko
Department of Clinical Physiology, Fujita Health University School of Medical Sciences, Toyoake, Japan.
Department of Clinical Laboratory, Fujita Health University Hospital, Toyoake, Japan.
Epilepsia Open. 2025 Feb;10(1):107-119. doi: 10.1002/epi4.13032. Epub 2024 Dec 3.
Epilepsy treatment with anti-seizure medications (ASMs) is based on careful assessment of the balance between the likelihood of further seizures and the risk of side effects of treatment. However, there is currently no established biomarker to ascertain seizure control status with ASMs. High-frequency oscillations (HFOs), transient bursts of EEG activity with frequencies beyond 80 Hz, are a new and promising noninvasive epilepsy biomarker. We compared the risk of scalp HFO appearance between pediatric patients with good and poor seizure control by treatment with ASMs.
A total of 72 epilepsy patients (aged 0-18 years, 39 males) with good and poor seizure control with ASMs participated in this study. We applied a validated automated detector to determine HFO and spike. We calculated the odds ratios (ORs) for scalp HFO and spike appearance according to seizure control status by multiple logistic regression analysis.
Scalp HFO was seen more commonly and with a significantly higher detection rate in patients with poor seizure control as compared with patients with good seizure control for both ripple and fast ripple. These significant associations were found for both focal and generalized epilepsy. The ORs for scalp HFO appearance adjusted for confounding factors were significantly higher in patients with poor seizure control compared to those with good seizure control (ripple: OR [95% CI] = 11.91 [2.21-64.30], p = 0.004; fast ripple: 4.98 [1.03-24.09], p = 0.046). There were no significant associations between spike appearance and seizure control status.
We found an increased risk of scalp HFO appearance in patients with poor seizure control. The results of this study support that scalp HFO is associated with patients having frequent seizures after treatment in both ripple and fast ripple.
This study analyzed scalp high-frequency oscillations and spikes in pediatric patients with various types of epilepsy who were being treated using ASMs. The results showed that an increased risk of scalp HFO appearance was observed in patients with poor seizure control compared to those with good seizure control. These findings were observed in both the ripple (80-250 Hz) and fast ripple (250-500 Hz) bands. The scalp HFO is associated with patients having frequent seizures after treatment in both ripple and fast ripple.
使用抗癫痫药物（ASMs）治疗癫痫是基于对进一步发作可能性与治疗副作用风险之间平衡的仔细评估。然而，目前尚无确定ASMs癫痫控制状态的生物标志物。高频振荡（HFOs）是脑电图（EEG）活动频率超过80Hz的短暂爆发，是一种新的、有前景的非侵入性癫痫生物标志物。我们比较了接受ASMs治疗的癫痫控制良好和不佳的儿科患者头皮HFO出现的风险。
共有72例接受ASMs治疗且癫痫控制良好和不佳的癫痫患者（年龄0 - 18岁，男性39例）参与本研究。我们应用经过验证的自动检测器来确定HFO和棘波。通过多因素逻辑回归分析，我们根据癫痫控制状态计算头皮HFO和棘波出现的比值比（ORs）。
与癫痫控制良好的患者相比，癫痫控制不佳的患者中头皮HFO更常见，且在涟漪波和快涟漪波中的检测率显著更高。在局灶性癫痫和全身性癫痫中均发现了这些显著关联。调整混杂因素后，癫痫控制不佳的患者头皮HFO出现的ORs显著高于癫痫控制良好的患者（涟漪波：OR [95%可信区间] = 11.91 [2.21 - 64.30]，p = 0.004；快涟漪波：4.98 [1.03 - 24.09]，p = 0.046）。棘波出现与癫痫控制状态之间无显著关联。
我们发现癫痫控制不佳的患者头皮HFO出现的风险增加。本研究结果支持头皮HFO在涟漪波和快涟漪波中均与治疗后频繁发作的患者相关。
本研究分析了使用ASMs治疗的各类癫痫儿科患者的头皮高频振荡和棘波。结果显示，与癫痫控制良好的患者相比，癫痫控制不佳的患者头皮HFO出现的风险增加。在涟漪波（80 - 250Hz）和快涟漪波（250 - 500Hz）频段均观察到了这些发现。头皮HFO在涟漪波和快涟漪波中均与治疗后频繁发作的患者相关。
