Interictal high-frequency oscillations in focal human epilepsy.

Abstract:

PURPOSE OF REVIEW:Localization of focal epileptic brain is critical for successful epilepsy surgery and focal brain stimulation. Despite significant progress, roughly half of all patients undergoing focal surgical resection, and most patients receiving focal electrical stimulation, are not seizure free. There is intense interest in high-frequency oscillations (HFOs) recorded with intracranial electroencephalography as potential biomarkers to improve epileptogenic brain localization, resective surgery, and focal electrical stimulation. The present review examines the evidence that HFOs are clinically useful biomarkers. RECENT FINDINGS:Performing the PubMed search 'High-Frequency Oscillations and Epilepsy' for 2013-2015 identifies 308 articles exploring HFO characteristics, physiological significance, and potential clinical applications. SUMMARY:There is strong evidence that HFOs are spatially associated with epileptic brain. There remain, however, significant challenges for clinical translation of HFOs as epileptogenic brain biomarkers: Differentiating true HFO from the high-frequency power changes associated with increased neuronal firing and bandpass filtering sharp transients. Distinguishing pathological HFO from normal physiological HFO. Classifying tissue under individual electrodes as normal or pathological. Sharing data and algorithms so research results can be reproduced across laboratories. Multicenter prospective trials to provide definitive evidence of clinical utility.

journal_name

Curr Opin Neurol

authors

Cimbalnik J,Kucewicz MT,Worrell G

doi

10.1097/WCO.0000000000000302

subject

Has Abstract

pub_date

2016-04-01 00:00:00

pages

175-81

issue

2

eissn

1350-7540

issn

1473-6551

pii

00019052-201604000-00011

journal_volume

29

pub_type

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