Evidence map›Paper›PMID 32753439›Full record

ArticleNeurology2020

Association of fast ripples on intracranial EEG and outcomes after epilepsy surgery.

Päivi Nevalainen, Nicolás von Ellenrieder, Petr Klimeš, François Dubeau, Birgit Frauscher, Jean Gotman

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
38citing papers in PubMed, 1 pooled it
6.5field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

38 citing papers in PubMed, 1 synthesis or guideline pooled it, 68 citations in OpenAlex.

  1. Pooled it
  2. Internal and external validation of comprehensive high-frequency activity biomarkers for epilepsy surgery.Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology · 2026
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  9. Layer 6 Corticothalamic Neurons Induce High Gamma Oscillations Through Cortico-cortical and Cortico-thalamo-cortical Pathways.The Journal of neuroscience : the official journal of the Society for Neuroscience · 2025
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  10. Article
  11. Article
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  14. To plan efficacious epilepsy surgery.Brain : a journal of neurology · 2024
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  17. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Päivi NevalainenFrom the Montreal Neurological Institute and Hospital (P.N., N.v.E., P.K., F.D., B.F., J.G.), McGill University, Quebec, Canada; and Department of Clinical Neurophysiology (P.N.), Children´s Hospital, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Finland. paivi.nevalainen@hus.fi.
Nicolás von EllenriederFrom the Montreal Neurological Institute and Hospital (P.N., N.v.E., P.K., F.D., B.F., J.G.), McGill University, Quebec, Canada; and Department of Clinical Neurophysiology (P.N.), Children´s Hospital, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Finland.
Petr KlimešFrom the Montreal Neurological Institute and Hospital (P.N., N.v.E., P.K., F.D., B.F., J.G.), McGill University, Quebec, Canada; and Department of Clinical Neurophysiology (P.N.), Children´s Hospital, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Finland.
François DubeauFrom the Montreal Neurological Institute and Hospital (P.N., N.v.E., P.K., F.D., B.F., J.G.), McGill University, Quebec, Canada; and Department of Clinical Neurophysiology (P.N.), Children´s Hospital, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Finland.
Birgit FrauscherFrom the Montreal Neurological Institute and Hospital (P.N., N.v.E., P.K., F.D., B.F., J.G.), McGill University, Quebec, Canada; and Department of Clinical Neurophysiology (P.N.), Children´s Hospital, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Finland.
Jean GotmanFrom the Montreal Neurological Institute and Hospital (P.N., N.v.E., P.K., F.D., B.F., J.G.), McGill University, Quebec, Canada; and Department of Clinical Neurophysiology (P.N.), Children´s Hospital, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Finland.
University of Helsinki · FI

Funding

CIHR FDN 143208
6 · The paper itself

Abstract

objectiveTo examine whether fast ripples (FRs) are an accurate marker of the epileptogenic zone, we analyzed overnight stereo-EEG recordings from 43 patients and hypothesized that FR resection ratio, maximal FR rate, and FR distribution predict postsurgical seizure outcome.

methodsWe detected FRs automatically from an overnight recording edited for artifacts and visually from a 5-minute period of slow-wave sleep. We examined primarily the accuracy of removing ≥50% of total FR events or of channels with FRs to predict postsurgical seizure outcome (Engel class I = good, classes II-IV = poor) according to the whole-night and 5-minute analysis approaches. Secondarily, we examined the association of low overall FR rates or absence or incomplete resection of 1 dominant FR area with poor outcome.

resultsThe accuracy of outcome prediction was highest (81%, 95% confidence interval [CI] 67%-92%) with the use of the FR event resection ratio and whole-night recording (vs 72%, 95% CI 56%-85%, for the visual 5-minute approach). Absence of channels with FR rates >6/min (

conclusionsFRs are accurate in predicting epilepsy surgery outcome at the individual level when overnight recordings are used. Absence of channels with high FR rates or absence of 1 dominant FR area is a poor prognostic factor that may reflect suboptimal spatial sampling of the epileptogenic zone or multifocality, rather than an inherently low sensitivity of FRs. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that FRs are accurate in predicting epilepsy surgery outcome.

Indexed as

Brain WavesElectroencephalographyAdolescentAdultBrainEpilepsyFemaleHumansMaleSensitivity and SpecificityTreatment OutcomeYoung Adult

Identifiers

PMID32753439
PMCPMC7713787
OpenAlexW3047267274

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.