Value of cortical high-frequency gamma oscillations with electrocorticography in location of epileptogenic zone

Objective To investigate the value of high-gamma oscillations (65~100 Hz) in epileptogenic foci localization by analyzing the intraoperative electrocorticography (ECoG) in patients with refractory temporal lobe epilepsy, along with comparing the occurrence rate and distribution characteristics of hi...

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Main Authors: LIAN Huan, DAN Wei, WEI Yu, XIE Yanfeng, SHI Quanhong, ZHAN Yan, SUN Xiaochuan
Format: Article
Language:zho
Published: Editorial Office of Journal of Third Military Medical University 2021-08-01
Series:Di-san junyi daxue xuebao
Subjects:
Online Access:http://aammt.tmmu.edu.cn/Upload/rhtml/202102036.htm
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author LIAN Huan
DAN Wei
WEI Yu
XIE Yanfeng
SHI Quanhong
ZHAN Yan
SUN Xiaochuan
author_facet LIAN Huan
DAN Wei
WEI Yu
XIE Yanfeng
SHI Quanhong
ZHAN Yan
SUN Xiaochuan
author_sort LIAN Huan
collection DOAJ
description Objective To investigate the value of high-gamma oscillations (65~100 Hz) in epileptogenic foci localization by analyzing the intraoperative electrocorticography (ECoG) in patients with refractory temporal lobe epilepsy, along with comparing the occurrence rate and distribution characteristics of high-gamma activity as well as spike wave inside and outside the irritative zone and around the foci. Methods A retrospective analysis was carried out on the intraoperative ECoG data of 21 patients with refractory temporal lobe epilepsy in our hospital from January 2013 to January 2019. The channels with interictal epileptiform discharges (IEDs) were defined as irritated area, and those without IEDs as non-irritated area. Based on the preoperative imaging data, intraoperative navigation combined with neurosurgeon's judgment, the monitoring cortical area was divided into focal area, perifocal area and the area away from the focus. Then the occurrence rate and distribution characteristics of IEDs (filter range: 1~30 Hz) and high-gamma were compared, and the distribution of high-gamma activity inside and outside the irritated area, and the incidence of high-gamma around the foci were analyzed. Results ① The overall incidence of IEDs and of high-gamma in the 21 patients were both 100.0% (21/21), and the average number of channels for IEDs, high-gamma and gamma+IEDs was 9.50±2.80, 8.14±2.93 and 6.60±2.40, respectively, indicating notably more IEDs channels than the other 2, by RM one-way ANOVA (P < 0.05). ②The channel numbers of high-gamma were 6.60±2.40 and 1.50±1.30 in the irritated and non-irritated areas respectively, and the event rates were 0.42±0.30 and 0.20±0.20 respectively, showing significant difference between the 2 areas (P < 0.01). ③The event numbers of high-gamma activity were 46.00±42.00, 33.40±32.90 and 8.40±9.40 in the focal area, the perifocal area and the area away from the focus, respectively, with the corresponding event rate of 0.40±0.30, 0.37±0.38 and 0.10±0.10, respectively. There were no significant differences in the event numbers and rates between the focal and perifocal area, though they were both significantly higher than that of the area away from the focus, by paired t-test (P < 0.05). Conclusion Traditional IEDs of ECoG are still an important marker to guide the range of resection intra-operatively in epilepsy surgery, while high-gamma presents great consistency with both IEDs and foci, with more accurate identification of epileptogenic zone than IEDs. Therefore, IEDs combined with high-gamma may have greater value in the localization of epileptogenic zone.
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spelling doaj.art-710cfa58855b4cc9b60fab5a6aaab5f12022-12-21T23:17:15ZzhoEditorial Office of Journal of Third Military Medical UniversityDi-san junyi daxue xuebao1000-54042021-08-0143151465147010.16016/j.1000-5404.202102036Value of cortical high-frequency gamma oscillations with electrocorticography in location of epileptogenic zoneLIAN Huan0DAN Wei1WEI Yu2XIE Yanfeng3SHI Quanhong4ZHAN Yan5SUN Xiaochuan6Department of Neurosurgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China Department of Neurosurgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China Department of Neurosurgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China Department of Neurosurgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China Department of Neurosurgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China Department of Neurosurgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China Department of Neurosurgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China Objective To investigate the value of high-gamma oscillations (65~100 Hz) in epileptogenic foci localization by analyzing the intraoperative electrocorticography (ECoG) in patients with refractory temporal lobe epilepsy, along with comparing the occurrence rate and distribution characteristics of high-gamma activity as well as spike wave inside and outside the irritative zone and around the foci. Methods A retrospective analysis was carried out on the intraoperative ECoG data of 21 patients with refractory temporal lobe epilepsy in our hospital from January 2013 to January 2019. The channels with interictal epileptiform discharges (IEDs) were defined as irritated area, and those without IEDs as non-irritated area. Based on the preoperative imaging data, intraoperative navigation combined with neurosurgeon's judgment, the monitoring cortical area was divided into focal area, perifocal area and the area away from the focus. Then the occurrence rate and distribution characteristics of IEDs (filter range: 1~30 Hz) and high-gamma were compared, and the distribution of high-gamma activity inside and outside the irritated area, and the incidence of high-gamma around the foci were analyzed. Results ① The overall incidence of IEDs and of high-gamma in the 21 patients were both 100.0% (21/21), and the average number of channels for IEDs, high-gamma and gamma+IEDs was 9.50±2.80, 8.14±2.93 and 6.60±2.40, respectively, indicating notably more IEDs channels than the other 2, by RM one-way ANOVA (P < 0.05). ②The channel numbers of high-gamma were 6.60±2.40 and 1.50±1.30 in the irritated and non-irritated areas respectively, and the event rates were 0.42±0.30 and 0.20±0.20 respectively, showing significant difference between the 2 areas (P < 0.01). ③The event numbers of high-gamma activity were 46.00±42.00, 33.40±32.90 and 8.40±9.40 in the focal area, the perifocal area and the area away from the focus, respectively, with the corresponding event rate of 0.40±0.30, 0.37±0.38 and 0.10±0.10, respectively. There were no significant differences in the event numbers and rates between the focal and perifocal area, though they were both significantly higher than that of the area away from the focus, by paired t-test (P < 0.05). Conclusion Traditional IEDs of ECoG are still an important marker to guide the range of resection intra-operatively in epilepsy surgery, while high-gamma presents great consistency with both IEDs and foci, with more accurate identification of epileptogenic zone than IEDs. Therefore, IEDs combined with high-gamma may have greater value in the localization of epileptogenic zone.http://aammt.tmmu.edu.cn/Upload/rhtml/202102036.htmelectrocorticographyepilepsyinterictal epileptiform dischargeshigh frequency oscillationsepileptogenic zone
spellingShingle LIAN Huan
DAN Wei
WEI Yu
XIE Yanfeng
SHI Quanhong
ZHAN Yan
SUN Xiaochuan
Value of cortical high-frequency gamma oscillations with electrocorticography in location of epileptogenic zone
Di-san junyi daxue xuebao
electrocorticography
epilepsy
interictal epileptiform discharges
high frequency oscillations
epileptogenic zone
title Value of cortical high-frequency gamma oscillations with electrocorticography in location of epileptogenic zone
title_full Value of cortical high-frequency gamma oscillations with electrocorticography in location of epileptogenic zone
title_fullStr Value of cortical high-frequency gamma oscillations with electrocorticography in location of epileptogenic zone
title_full_unstemmed Value of cortical high-frequency gamma oscillations with electrocorticography in location of epileptogenic zone
title_short Value of cortical high-frequency gamma oscillations with electrocorticography in location of epileptogenic zone
title_sort value of cortical high frequency gamma oscillations with electrocorticography in location of epileptogenic zone
topic electrocorticography
epilepsy
interictal epileptiform discharges
high frequency oscillations
epileptogenic zone
url http://aammt.tmmu.edu.cn/Upload/rhtml/202102036.htm
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