Prognostic value of high-frequency oscillations combined with multimodal imaging methods for epilepsy surgery

作     者：Xiaoming Yan Fangzhao Yin Cuiping Xu Tao Yu Xiaonan Li Wei Wang Xi Zhang Kai Ma Guojun Zhang Xiaoming Yan;Fangzhao Yin;Cuiping Xu;Tao Yu;Xiaonan Li;Wei Wang;Xi Zhang;Kai Ma;Guojun Zhang

作者机构：Beijing Institute of Functional NeurosurgeryXuanwu HospitalCapital Medical UniversityBeijing 100053China Beijing Institute of Brain DisordersLaboratory of Brain DisordersMinistry of Science and TechnologyCollaborative Innovation Center for Brain DisordersCapital Medical UniversityBeijing 100069China Bioland Laboratory Guangzhou Regenerative Medicine and Health Guangdong LaboratoryGuangzhouGuangdong 510005China 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2022年第135卷第9期

页      面：1087-1095页

核心收录：

学科分类：1002[医学-临床医学] 10[医学] 

基　　金：Beijing Natural Science Foundation(No.L182015) the Beijing Hospitals Authority’s Ascent Plan(No.DFL20190801)。 

主　　题：High-frequency oscillations Ripples PET MEG Epileptogenic zone 

摘      要：Background:The combination of high-frequency oscillations(HFOs)with single-mode imaging methods has been proved useful in identifying epileptogenic zones,whereas few studies have examined HFOs combined with multimodal imaging methods.The aim of this study was to evaluate the prognostic value of ripples,an HFO subtype with a frequency of 80 to 200 Hz is combined with multimodal imaging methods in predicting epilepsy surgery outcome.Methods:HFOs were analyzed in 21 consecutive medically refractory epilepsy patients who underwent epilepsy surgery.All patients underwent positron emission tomography(PET)and deep electrode implantation for stereo-electroencephalography(SEEG);11 patients underwent magnetoencephalography(MEG).Sensitivity,specificity,positive predictive value,negative predictive value,and accuracy in predicting surgical outcome were calculated for ripples combined with PET,MEG,both PET and MEG,and PET combined with MEG.Kaplan-Meier survival analyses were conducted in each group to estimate prognostic value.Results:The study included 13 men and 8 women.Accuracy for ripples,PET,and MEG alone in predicting surgical outcome was 42.9%,42.9%,and 81.8%,respectively.Accuracy for ripples combined with PET and MEG was the highest.Resection of regions identified by ripples,MEG dipoles,and combined PET findings was significantly associated with better surgical outcome(P0.05).Conclusions:Intracranial electrodes are essential to detect regions which generate ripples and to remove these areas which indicate good surgical outcome for medically intractable epilepsy.With the assistance of presurgical noninvasive imaging examinations,PET and MEG,for example,the SEEG electrodes would identify epileptogenic regions more effectively.