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. 2019 Oct;130(10):1882-1888.
doi: 10.1016/j.clinph.2019.07.008. Epub 2019 Jul 23.

High-density ECoG improves the detection of high frequency oscillations that predict seizure outcome

Ece Boran  1 , Georgia Ramantani  2 , Niklaus Krayenbühl  1 , Maxine Schreiber  1 , Kristina König  3 , Tommaso Fedele  4 , Johannes Sarnthein  5
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Free article

High-density ECoG improves the detection of high frequency oscillations that predict seizure outcome

Ece Boran et al. Clin Neurophysiol. 2019 Oct.
Free article

Abstract

Objectives: Residual fast ripples (FR) in the intraoperative ECoG are highly specific predictors of postsurgical seizure recurrence. However, a FR is generated by a small patch of cortical tissue. Spatial sampling with standard electrodes may thus miss clinically relevant information.

Methods: We analyzed FR rates in the intraoperative ECoG of 22 patients that underwent resective epilepsy surgery. We used standard electrodes with 10 mm inter-contact spacing (standard ECoG) in 14 surgeries and high-density grid electrodes with 5 mm spacing (hd-ECoG) in 8 surgeries. We detected FR using a previously validated automatic detector.

Results: Postoperative seizure freedom was achieved in 14/22 (64%) cases. Across all 42 ECoG recordings, FR rates were higher for hd-ECoG than for standard ECoG. In the 14 seizure free patients (ILAE 1), no residual FR were detected (specificity = 100%). In the 8 patients with seizure recurrence (ILAE > 1), residual FR were detected in 1/7 standard ECoG and 1/1 hd-ECoG (Accuracy ACCstandard ECoG = 57%, CI [29% 82%], ACChd-ECoG = 100%, CI [63% 100%]).

Conclusion: Denser spatial sampling by hd-ECoG improved FR detection compared to standard ECoG.

Significance: Hd-ECoG may advance seizure freedom after epilepsy surgery.

Keywords: Epilepsy surgery; Fast Ripple; Intraoperative recording; Resection area; Seizure outcome.

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