ArticleAnnals of clinical and translational neurology2025
Very High-Frequency Oscillations in Mesial Temporal Lobe Epilepsy: Identifying the Epileptogenic Zone.
Article in Annals of clinical and translational neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Abstract
objectiveTo investigate the reliability of very high-frequency oscillations (VHFOs, 500-2000 Hz) as biomarkers in identifying the epileptogenic zone (EZ) in mesial temporal lobe epilepsy (MTLE) patients.
methodsWe reviewed 19 MTLE patients who underwent stereo-electroencephalography-guided radiofrequency thermocoagulation. Interictal and ictal VHFOs were captured in four regions of interest (ROIs): amygdalohippocampal complex (AHC), parahippocampal gyrus (PG), white matter, and lateral temporal lobe. We analyzed the occurrence of VHFOs per minute, per contact: (a) in each ROI; (b) during awake resting state, sleep, and seizure within the seizure onset zone (SOZ) and non-SOZ contacts; (c) in the EZ, propagation zone (PZ), and non-involved zone (NIZ). The percentage and ratio of thermocoagulated VHFOs contacts in seizure-free (SF) and non-seizure-free (NSF) patients were also analyzed.
resultsAt the last follow-up (19.31 ± 6.36 months), 13 patients were SF and 6 were NSF. The VHFOs rate was significantly higher in the SOZ contacts during the ictal than interictal period compared to non-SOZ contacts. Very-fast ripples rate was more prevalent in the EZ than in the NIZ. VHFOs rate was higher in the AHC and PG compared to other regions. At a group level, SF patients had a higher percentage and ratio of thermocoagulated VHFOs contacts compared to NSF patients. At a patient level, some NSF patients had most of their VHFO-generating tissues ablated, while some SF did not.
interpretationThe presence and ablation of VHFO-generating areas was associated with good surgical outcome at a group level. However, at a patient level, VHFOs may not be as reliable in identifying the EZ.
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