Multicentre analysis of seizure outcome predicted by removal of high-frequency oscillations

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00159816%3A_____%2F25%3A00082281" target="_blank" >RIV/00159816:_____/25:00082281 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00216224:14110/25:00140389

Výsledek na webu

<a href="https://academic.oup.com/brain/article/148/5/1769/7891549?searchresult=1" target="_blank" >https://academic.oup.com/brain/article/148/5/1769/7891549?searchresult=1</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1093/brain/awae361" target="_blank" >10.1093/brain/awae361</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Multicentre analysis of seizure outcome predicted by removal of high-frequency oscillations

Popis výsledku v původním jazyce

In drug-resistant focal epilepsy, planning surgical resection can involve presurgical intracranial EEG (iEEG) recordings to detect seizures and other iEEG patterns to improve postsurgical seizure outcome. We hypothesized that resection of tissue generating interictal high-frequency oscillations (HFOs, 80-500 Hz) in the iEEG predicts surgical outcome.In eight international epilepsy centres, iEEG was recorded during the presurgical evaluation of patients. The patients were of all ages, had epilepsy of all types, and underwent surgical resection of a single focus aiming at seizure freedom. In a prospective analysis, we applied a fully automated definition of HFO that was independent of the dataset. Using an observational cohort design that was blinded to postsurgical seizure outcome, we analysed HFO rates during non-rapid-eye-movement sleep. If channels had consistently high rates over multiple epochs, they were labelled the &apos;HFO area&apos;. After HFO analysis, centres provided the electrode contacts located in the resected volume and the seizure outcome at follow-up &gt;= 24 months after surgery. The study was registered at www.clinicaltrials.gov (NCT05332990).We received 160 iEEG datasets. In 146 datasets (91%), the HFO area could be defined. The patients with a completely resected HFO area were more likely to achieve seizure freedom in comparison to those without [odds ratio 2.61, 95% confidence interval (CI) 1.15-5.91, P = 0.02]. Among seizure-free patients, the HFO area was completely resected in 31 and not completely resected in 43. Among patients with recurrent seizures, the HFO area was completely resected in 14 and not completely resected in 58. When predicting seizure freedom, the negative predictive value of the HFO area (68%, CI 52-81) was higher than that for the resected volume as a predictor by itself (51%, CI 42-59, P = 4 x 10-5). The sensitivity and specificity for complete HFO area resection were 0.88 (CI 0.72-0.98) and 0.39 (CI 0.25-0.54), respectively, and the area under the curve was 0.83 (CI 0.58-0.97), indicating good predictive performance.In a blinded cohort study from independent epilepsy centres, applying a previously validated algorithm for HFO marking without the need for adjusting to new datasets allowed us to validate the clinical relevance of HFOs to plan the surgical resection. Can postsurgical seizure outcomes in epilepsy patients be improved? In an observational study based on prospective blinded analysis of intracranial recordings, Dimakopoulos et al. found that removal of the area of brain tissue generating high frequency oscillations was associated with higher rates of seizure freedom.

Název v anglickém jazyce

Multicentre analysis of seizure outcome predicted by removal of high-frequency oscillations

Popis výsledku anglicky

In drug-resistant focal epilepsy, planning surgical resection can involve presurgical intracranial EEG (iEEG) recordings to detect seizures and other iEEG patterns to improve postsurgical seizure outcome. We hypothesized that resection of tissue generating interictal high-frequency oscillations (HFOs, 80-500 Hz) in the iEEG predicts surgical outcome.In eight international epilepsy centres, iEEG was recorded during the presurgical evaluation of patients. The patients were of all ages, had epilepsy of all types, and underwent surgical resection of a single focus aiming at seizure freedom. In a prospective analysis, we applied a fully automated definition of HFO that was independent of the dataset. Using an observational cohort design that was blinded to postsurgical seizure outcome, we analysed HFO rates during non-rapid-eye-movement sleep. If channels had consistently high rates over multiple epochs, they were labelled the &apos;HFO area&apos;. After HFO analysis, centres provided the electrode contacts located in the resected volume and the seizure outcome at follow-up &gt;= 24 months after surgery. The study was registered at www.clinicaltrials.gov (NCT05332990).We received 160 iEEG datasets. In 146 datasets (91%), the HFO area could be defined. The patients with a completely resected HFO area were more likely to achieve seizure freedom in comparison to those without [odds ratio 2.61, 95% confidence interval (CI) 1.15-5.91, P = 0.02]. Among seizure-free patients, the HFO area was completely resected in 31 and not completely resected in 43. Among patients with recurrent seizures, the HFO area was completely resected in 14 and not completely resected in 58. When predicting seizure freedom, the negative predictive value of the HFO area (68%, CI 52-81) was higher than that for the resected volume as a predictor by itself (51%, CI 42-59, P = 4 x 10-5). The sensitivity and specificity for complete HFO area resection were 0.88 (CI 0.72-0.98) and 0.39 (CI 0.25-0.54), respectively, and the area under the curve was 0.83 (CI 0.58-0.97), indicating good predictive performance.In a blinded cohort study from independent epilepsy centres, applying a previously validated algorithm for HFO marking without the need for adjusting to new datasets allowed us to validate the clinical relevance of HFOs to plan the surgical resection. Can postsurgical seizure outcomes in epilepsy patients be improved? In an observational study based on prospective blinded analysis of intracranial recordings, Dimakopoulos et al. found that removal of the area of brain tissue generating high frequency oscillations was associated with higher rates of seizure freedom.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30210 - Clinical neurology

Projekt

Výsledek vznikl pri realizaci vícero projektů. Více informací v záložce Projekty.

Návaznosti

P - Projekt vyzkumu a vyvoje financovany z verejnych zdroju (s odkazem do CEP)

Rok uplatnění

2025

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Brain

ISSN

0006-8950

e-ISSN

1460-2156

Svazek periodika

148

Číslo periodika v rámci svazku

5

Stát vydavatele periodika

GB - Spojené království Velké Británie a Severního Irska

Počet stran výsledku

9

Strana od-do

1769-1777

Kód UT WoS článku

001449093300001

EID výsledku v databázi Scopus

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