ArticleNeurology2025
Dynamic Interplay Between Wake Slow Waves and Epileptiform Discharges in the Epileptogenic Zone.
Article in Neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Brain-wide properties of slow waves across vigilance states.Sleep advances : a journal of the Sleep Research Society · 2026Article
- EEG focal delta slowing in focal epilepsy - A didactic review.Clinical neurophysiology practice · 2025Review
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Authors and funding
8 authors.
Funding
Abstract
BACKGROUND AND
objectivesOutcome of epilepsy surgery remains suboptimal, calling for the identification of new, complementary biomarkers of the epileptogenic zone (EZ). Recently, we identified local wake slow waves (LoWS) as a potential regulator of network excitability that interacts with interictal epileptiform discharges (IEDs). In this study, we tested whether this interaction is associated with surgical outcome.
methodsIn this retrospective study, we analyzed intracranial recordings from patients with intractable focal epilepsy who underwent surgery at the Hospital of the University of Pennsylvania. We used surgical success as an indicator that most or all of the EZ had been resected. We used linear mixed models to test whether the incidence of IEDs and LoWS, as well as their interaction, can accurately delineate the EZ in patients with successful vs poor outcome.
resultsAcross 55 patients (30 women, mean age ±SD: 34 ± 10 years), we found that, although IEDs were more frequent in the seizure-onset zone, their rate in resected and nonresected areas was not associated with surgical success. Indeed, neither the rate of IEDs (F [1, 52.57] = 0.070, DISCUSSION: The temporal proximity of LoWS to a preceding IED in the resected cortex is associated with surgical outcome. This may reflect changes in the regulation of network excitability in the EZ as a form of homeostatic regulation. It raises the possibility to use this index as an additional prognostic biomarker in epilepsy surgery.
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