scholarly journals Interictal high frequency background activity as a biomarker of epileptogenic tissue

2021 ◽  
Author(s):  
Truman Stovall ◽  
Brian Hunt ◽  
Simon Glynn ◽  
William C Stacey ◽  
Stephen V Gliske
Keyword(s):  
Logistic Regression ◽  
Confidence Interval ◽  
High Frequency ◽  
High Frequency Oscillation ◽  
Epileptogenic Zone ◽  
Odds Ratios ◽  
Seizure Onset ◽  
High Frequency Oscillations ◽  
Seizure Onset Zone ◽  
Background Data

Abstract High Frequency Oscillations are very brief events that are a well-established biomarker of the epileptogenic zone, but are rare and comprise only a tiny fraction of the total recorded EEG. We hypothesize that the interictal high frequency “background” data, which has received little attention but represents the majority of the EEG record, also may contain additional, novel information for identifying the epileptogenic zone. We analyzed intracranial EEG (30–500 Hz frequency range) acquired from 24 patients who underwent resective surgery. We computed 38 quantitative features based on all usable, interictal data (63–307 hours per subject), excluding all detected high frequency oscillations. We assessed association between each feature and the seizure onset zone and resected volume using logistic regression. A pathology score per channel was also created via principle component analysis and logistic regression, using hold-out-one-patient cross validation to avoid in-sample training. Association of the pathology score with the seizure onset zone and resected volume was quantified using an asymmetry measure. Many features were associated with the seizure onset zone: 23/38 features had odds ratios >1.3 or < 0.7 and 17/38 had odds ratios different than zero with high significance (p < 0.001/39, logistic regression with Bonferroni Correction). The pathology score, the rate of high frequency oscillations, and their channel-wise product were each strongly associated with the seizure onset zone (median asymmetry > =0.44, good surgery outcome patients; median asymmetry > =0.40, patients with other outcomes; 95% confidence interval > 0.27 in both cases). The pathology score and the channel-wise product also had higher asymmetry with respect to the seizure onset zone than the high frequency oscillation rate alone (median difference in asymmetry > =0.18, 95% confidence interval >0.05). These results support that the high frequency background data contains useful information for determining the epileptogenic zone, distinct and complementary to information from detected high frequency oscillations. The concordance between the high frequency activity pathology score and the rate of high frequency oscillations appears to be a better biomarker of epileptic tissue than either measure alone.

scholarly journals Stable high frequency background EEG activity distinguishes epileptic from healthy brain regions

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Annika Minthe ◽  
Wibke G Janzarik ◽  
Daniel Lachner-Piza ◽  
Peter Reinacher ◽  
Andreas Schulze-Bonhage ◽  
...  
Keyword(s):  
High Frequency ◽  
Background Activity ◽  
Sleep Stage ◽  
Strong Association ◽  
Brain Regions ◽  
High Frequency Oscillation ◽  
Seizure Onset ◽  
High Frequency Oscillations ◽  
Seizure Onset Zone ◽  
Low Entropy

Abstract High-frequency oscillations are markers of epileptic tissue. Recently, different patterns of EEG background activity were described from which high-frequency oscillations occur: high-frequency oscillations with continuously oscillating background were found to be primarily physiological, those from quiet background were linked to epileptic tissue. It is unclear, whether these interactions remain stable over several days and during different sleep-wake stages. High-frequency oscillation patterns (oscillatory vs. quiet background) were analysed in 23 patients implanted with depth and subdural grid electrodes. Pattern scoring was performed on every channel in 10 s intervals in three separate day- and night-time EEG segments. An entropy value, measuring variability of patterns per channel, was calculated. A low entropy value indicated a stable occurrence of the same pattern in one channel, whereas a high value indicated pattern instability. Differences in pattern distribution and entropy were analysed for 143 280 10 s intervals with allocated patterns from inside and outside the seizure onset zone, different electrode types and brain regions. We found a strong association between high-frequency oscillations out of quiet background activity, and channels of the seizure onset zone (35.2% inside versus 9.7% outside the seizure onset zone, P < 0.001), no association was found for high-frequency oscillations from continuous oscillatory background (P = 0.563). The type of background activity remained stable over the same brain region over several days and was independent of sleep stage and recording technique. Stability of background activity was significantly higher in channels of the seizure onset zone (entropy mean value 0.56 ± 0.39 versus 0.64 ± 0.41; P < 0.001). This was especially true for the presumed epileptic high-frequency oscillations out of quiet background (0.57 ± 0.39 inside versus 0.72 ± 0.37 outside the seizure onset zone; P < 0.001). In contrast, presumed physiological high-frequency oscillations from continuous oscillatory backgrounds were significantly more stable outside the seizure onset zone (0.72 ± 0.45 versus 0.48 ± 0.53; P < 0.001). The overall low entropy values suggest that interactions between high-frequency oscillations and background activity are a stable phenomenon specific to the function of brain regions. High-frequency oscillations occurring from a quiet background are strongly linked to the seizure onset zone whereas high-frequency oscillations from an oscillatory background are not. Pattern stability suggests distinct underlying mechanisms. Analysing short time segments of high-frequency oscillations and background activity could help distinguishing epileptic from physiologically active brain regions.

Automated Seizure Onset Zone Approximation Based on Nonharmonic High-Frequency Oscillations in Human Interictal Intracranial EEGs

2015 ◽  
Vol 25 (05) ◽  
pp. 1550015 ◽  
Author(s):  
Evelien E. Geertsema ◽  
Gerhard H. Visser ◽  
Demetrios N. Velis ◽  
Steven P. Claus ◽  
Maeike Zijlmans ◽  
...  
Keyword(s):  
High Frequency ◽  
Surrogate Marker ◽  
Area Under The Curve ◽  
Roc Curves ◽  
Visual Observation ◽  
Epileptogenic Zone ◽  
Seizure Onset ◽  
High Frequency Oscillations ◽  
Residual Variation ◽  
Seizure Onset Zone

A novel automated algorithm is proposed to approximate the seizure onset zone (SOZ), while providing reproducible output. The SOZ, a surrogate marker for the epileptogenic zone (EZ), was approximated from intracranial electroencephalograms (iEEG) of nine people with temporal lobe epilepsy (TLE), using three methods: (1) Total ripple length (TRL): Manually segmented high-frequency oscillations, (2) Rippleness (R): Area under the curve (AUC) of the autocorrelation functions envelope, and (3) Autoregressive model residual variation (ARR, novel algorithm): Time-variation of residuals from autoregressive models of iEEG windows. TRL, R, and ARR results were compared in terms of separability, using Kolmogorov–Smirnov tests, and performance, using receiver operating characteristic (ROC) curves, to the gold standard for SOZ delineation: visual observation of ictal video-iEEGs. TRL, R, and ARR can distinguish signals from iEEG channels located within the SOZ from those outside it (p < 0.01). The ROC AUC was 0.82 for ARR, while it was 0.79 for TRL, and 0.64 for R. ARR outperforms TRL and R, and may be applied to identify channels in the SOZ automatically in interictal iEEGs of people with TLE. ARR, interpreted as evidence for nonharmonicity of high-frequency EEG components, could provide a new way to delineate the EZ, thus contributing to presurgical workup.

scholarly journals Patient-specific optimization of automated detection improves seizure onset zone localization based on high frequency oscillations

2020 ◽  
Author(s):  
Casey L. Trevino ◽  
Jack J. Lin ◽  
Indranil Sen-Gupta ◽  
Beth A. Lopour
Keyword(s):  
High Frequency ◽  
Classification Accuracy ◽  
Patient Specific ◽  
Seizure Onset ◽  
Data Set ◽  
Localization Accuracy ◽  
High Frequency Oscillations ◽  
Seizure Onset Zone ◽  
Wide Range ◽  
The Impact

AbstractHigh frequency oscillations (HFOs) are a promising biomarker of epileptogenicity, and automated algorithms are critical tools for their detection. However, previously validated algorithms often exhibit decreased HFO detection accuracy when applied to a new data set, if the parameters are not optimized. This likely contributes to decreased seizure localization accuracy, but this has never been tested. Therefore, we evaluated the impact of parameter selection on seizure onset zone (SOZ) localization using automatically detected HFOs. We detected HFOs in intracranial EEG from twenty medically refractory epilepsy patients with seizure free surgical outcomes using an automated algorithm. For each patient, we assessed classification accuracy of channels inside/outside the SOZ using a wide range of detection parameters and identified the parameters associated with maximum classification accuracy. We found that only three out of twenty patients achieved maximal localization accuracy using conventional HFO detection parameters, and optimal parameter ranges varied significantly across patients. The parameters for amplitude threshold and root-mean-square window had the greatest impact on SOZ localization accuracy; minimum event duration and rejection of false positive events did not significantly affect the results. Using individualized optimal parameters led to substantial improvements in localization accuracy, particularly in reducing false positives from non-SOZ channels. We conclude that optimal HFO detection parameters are patient-specific, often differ from conventional parameters, and have a significant impact on SOZ localization. This suggests that individual variability should be considered when implementing automatic HFO detection as a tool for surgical planning.

scholarly journals Spatial variation in high-frequency oscillation rates and amplitudes in intracranial EEG

Neurology ◽  
2018 ◽  
Vol 90 (8) ◽  
pp. e639-e646 ◽  
Author(s):  
Hari Guragain ◽  
Jan Cimbalnik ◽  
Matt Stead ◽  
David M. Groppe ◽  
Brent M. Berry ◽  
...  
Keyword(s):  
High Frequency ◽  
Anatomic Variation ◽  
Brain Regions ◽  
Brain Atlas ◽  
Reproducible Research ◽  
High Frequency Oscillation ◽  
Seizure Onset ◽  
Frequency Oscillation ◽  
Intracranial Eeg ◽  
Seizure Onset Zone

ObjectiveTo assess the variation in baseline and seizure onset zone interictal high-frequency oscillation (HFO) rates and amplitudes across different anatomic brain regions in a large cohort of patients.MethodsSeventy patients who had wide-bandwidth (5 kHz) intracranial EEG (iEEG) recordings during surgical evaluation for drug-resistant epilepsy between 2005 and 2014 who had high-resolution MRI and CT imaging were identified. Discrete HFOs were identified in 2-hour segments of high-quality interictal iEEG data with an automated detector. Electrode locations were determined by coregistering the patient's preoperative MRI with an X-ray CT scan acquired immediately after electrode implantation and correcting electrode locations for postimplant brain shift. The anatomic locations of electrodes were determined using the Desikan-Killiany brain atlas via FreeSurfer. HFO rates and mean amplitudes were measured in seizure onset zone (SOZ) and non-SOZ electrodes, as determined by the clinical iEEG seizure recordings. To promote reproducible research, imaging and iEEG data are made freely available (msel.mayo.edu).ResultsBaseline (non-SOZ) HFO rates and amplitudes vary significantly in different brain structures, and between homologous structures in left and right hemispheres. While HFO rates and amplitudes were significantly higher in SOZ than non-SOZ electrodes when analyzed regardless of contact location, SOZ and non-SOZ HFO rates and amplitudes were not separable in some lobes and structures (e.g., frontal and temporal neocortex).ConclusionsThe anatomic variation in SOZ and non-SOZ HFO rates and amplitudes suggests the need to assess interictal HFO activity relative to anatomically accurate normative standards when using HFOs for presurgical planning.

scholarly journals DC shifts, high frequency oscillations, ripples and fast ripples in relation to the seizure onset zone

Seizure ◽  
2020 ◽  
Vol 77 ◽  
pp. 52-58 ◽  
Author(s):  
Somin Lee ◽  
Naoum P. Issa ◽  
Sandra Rose ◽  
James X. Tao ◽  
Peter C. Warnke ◽  
...  
Keyword(s):  
High Frequency ◽  
Seizure Onset ◽  
High Frequency Oscillations ◽  
Seizure Onset Zone

High-Frequency Oscillations and Epileptogenic Network

2021 ◽  
Vol 19 ◽  
Author(s):  
Xiaonan Li ◽  
Herui Zhang ◽  
Huanling Lai ◽  
Jiaoyang Wang ◽  
Wei Wang ◽  
...  
Keyword(s):  
High Frequency ◽  
Large Scale ◽  
High Frequency Oscillation ◽  
Epileptogenic Zone ◽  
Network Development ◽  
High Frequency Oscillations ◽  
Frequency Coupling ◽  
Different Characteristics ◽  
The Relationship ◽  
Cross Frequency Coupling

: Epilepsy is a network disease caused by aberrant neocortical large-scale connectivity spanning regions on the scale of several centimeters. High-frequency oscillations, characterized by the 80–600 Hz signals in electroencephalography, have been proven to be a promising biomarker of epilepsy that can be used in assessing the severity and susceptibility of epilepsy as well as the location of the epileptogenic zone. However, the presence of a high-frequency oscillation network remains a topic of debate as high-frequency oscillations have been previously thought to be incapable of propagation, and the relationship between high-frequency oscillations and the epileptogenic network has rarely been discussed. Some recent studies reported that high-frequency oscillations may behave like networks that are closely relevant to the epileptogenic network. Pathological high-frequency oscillations are network-driven phenomena and elucidate epileptogenic network development; high-frequency oscillations show different characteristics coincident with the epileptogenic network dynamics, and cross-frequency coupling between high-frequency oscillations and other signals may mediate the generation and propagation of abnormal discharges across the network.

scholarly journals Kurtosis-Based Detection of Intracranial High-Frequency Oscillations for the Identification of the Seizure Onset Zone

2018 ◽  
Vol 28 (07) ◽  
pp. 1850001 ◽  
Author(s):  
Lucia Rita Quitadamo ◽  
Roberto Mai ◽  
Francesca Gozzo ◽  
Veronica Pelliccia ◽  
Francesco Cardinale ◽  
...  
Keyword(s):  
High Frequency ◽  
Computational Time ◽  
Seizure Onset ◽  
Time Frequency ◽  
High Frequency Oscillations ◽  
Epileptiform Discharges ◽  
Seizure Onset Zone ◽  
Potential Biomarker ◽  
Eeg Data

Pathological High-Frequency Oscillations (HFOs) have been recently proposed as potential biomarker of the seizure onset zone (SOZ) and have shown superior accuracy to interictal epileptiform discharges in delineating its anatomical boundaries. Characterization of HFOs is still in its infancy and this is reflected in the heterogeneity of analysis and reporting methods across studies and in clinical practice. The clinical approach to HFOs identification and quantification usually still relies on visual inspection of EEG data. In this study, we developed a pipeline for the detection and analysis of HFOs. This includes preliminary selection of the most informative channels exploiting statistical properties of the pre-ictal and ictal intracranial EEG (iEEG) time series based on spectral kurtosis, followed by wavelet-based characterization of the time–frequency properties of the signal. We performed a preliminary validation analyzing EEG data in the ripple frequency band (80–250 Hz) from six patients with drug-resistant epilepsy who underwent pre-surgical evaluation with stereo-EEG (SEEG) followed by surgical resection of pathologic brain areas, who had at least two-year positive post-surgical outcome. In this series, kurtosis-driven selection and wavelet-based detection of HFOs had average sensitivity of 81.94% and average specificity of 96.03% in identifying the HFO area which overlapped with the SOZ as defined by clinical presurgical workup. Furthermore, the kurtosis-based channel selection resulted in an average reduction in computational time of 66.60%.

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