ArticleEpilepsia2023
Spike patterns surrounding sleep and seizures localize the seizure-onset zone in focal epilepsy.
Article in Epilepsia, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 1 of them a synthesis that pooled it.
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Who cites it
34 citing papers in PubMed, 1 synthesis or guideline pooled it.
- EEG patterns in each phase of hemiplegic migraine: a systematic review and pooled prevalence meta-analysis.The journal of headache and pain · 2025Pooled it
- Article
- A multimodal epilepsy dataset of paired 3-Tesla and 7-Tesla MRI and intracranial EEG.Scientific data · 2026Article
- Thalamic interictal epileptic and non-epileptic events during NREM sleep in patients with focal epilepsy: a Stereo-EEG study.EBioMedicine · 2026Article
- Predicting surgical outcome in drug-resistant epilepsy by combining interictal biomarkers within a machine learning framework.Scientific reports · 2026Article
- Predicting Surgical Outcome in Drug-Resistant Epilepsy by Combining Interictal Biomarkers within a Machine Learning Framework.Research square · 2026Article
- Synchrony is a robust iEEG biomarker for antiseizure medication load in epileptic patients.bioRxiv : the preprint server for biology · 2026Article
- Spatiotemporal patterns differentiate hippocampal sharp-wave ripples from interictal epileptiform discharges in mice and humans.Nature communications · 2025Article
- Chronic 40 Hz light flicker mitigates epileptogenesis through a visual pathway associated with the dorsal lateral geniculate nucleus shell.Nature communications · 2025Article
- Potential ofEpilepsia open · 2025Article
- Dynamic Interplay Between Wake Slow Waves and Epileptiform Discharges in the Epileptogenic Zone.Neurology · 2025Article
- Can electrical stimulation replace spontaneous seizures in epilepsy surgery?medRxiv : the preprint server for health sciences · 2025Article
- Mesial-to-lateral gradients of epileptiform activity to localize mesial temporal lobe epilepsy.Epilepsia · 2025Article
- Visual Features in Stereo-Electroencephalography to Predict Surgical Outcome: A Multicenter Study.Annals of neurology · 2025Article
- Multimodal quantitative analysis guides precise preoperative localization of epilepsy.Journal of neurology · 2025Review
- Mechanistic insights into the interaction between epilepsy and sleep.Nature reviews. Neurology · 2025Review
- SEEG in 2025: progress and pending challenges in stereotaxy methods, biomarkers and radiofrequency thermocoagulation.Current opinion in neurology · 2025Review
- Lateralizing value of interictal epileptiform discharges and other parameters in hypothalamic hamartoma.Epilepsia · 2025Article
- Leveraging interictal multimodal features and graph neural networks for automated planning of epilepsy surgery.Brain communications · 2025Article
- Overlap of spike and ripple propagation onset predicts surgical outcome in epilepsy.Annals of clinical and translational neurology · 2024Article
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11 authors.
Funding
Abstract
objectiveInterictal spikes help localize seizure generators as part of surgical planning for drug-resistant epilepsy. However, there are often multiple spike populations whose frequencies change over time, influenced by brain state. Understanding state changes in spike rates will improve our ability to use spikes for surgical planning. Our goal was to determine the effect of sleep and seizures on interictal spikes, and to use sleep and seizure-related changes in spikes to localize the seizure-onset zone (SOZ).
methodsWe performed a retrospective analysis of intracranial electroencephalography (EEG) data from patients with focal epilepsy. We automatically detected interictal spikes and we classified different time periods as awake or asleep based on the ratio of alpha to delta power, with a secondary analysis using the recently published SleepSEEG algorithm. We analyzed spike rates surrounding sleep and seizures. We developed a model to localize the SOZ using state-dependent spike rates.
resultsWe analyzed data from 101 patients (54 women, age range 16-69). The normalized alpha-delta power ratio accurately classified wake from sleep periods (area under the curve = .90). Spikes were more frequent in sleep than wakefulness and in the post-ictal compared to the pre-ictal state. Patients with temporal lobe epilepsy had a greater wake-to-sleep and pre- to post-ictal spike rate increase compared to patients with extra-temporal epilepsy. A machine-learning classifier incorporating state-dependent spike rates accurately identified the SOZ (area under the curve = .83). Spike rates tended to be higher and better localize the seizure-onset zone in non-rapid eye movement (NREM) sleep than in wake or REM sleep. SIGNIFICANCE: The change in spike rates surrounding sleep and seizures differs between temporal and extra-temporal lobe epilepsy. Spikes are more frequent and better localize the SOZ in sleep, particularly in NREM sleep. Quantitative analysis of spikes may provide useful ancillary data to localize the SOZ and improve surgical planning.
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