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Updated: Apr 26, 2026
Author Spotlight: Advancing Pediatric Epilepsy Surgery in Children Through Novel Biomarkers and Enhanced Localization
Published on: September 20, 2024
Localization of sleep spindles, k-complexes, and vertex waves with subdural electrodes in children
Anna L R Pinto1, Iván S Fernández, Jurriaan M Peters
1*Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, U.S.A.; †Department of Child Neurology, Hospital Sant Joan de Déu, Universidad de Barcelona, Barcelona, Spain; ‡Department of Ophthalmology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, U.S.A.; §Department of Neurology, Boston University School of Medicine, Boston University, Boston, Massachusetts, U.S.A.; ‖Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, U.S.A.; and ¶Department of Neurology, Comprehensive Epilepsy Center, New York University Medical Center, New York University Langone School of Medicine, New York, New York, U.S.A.
Purpose:
To describe for the first time in children the localization of sleep spindles, K-complexes, and vertex waves using subdural electrodes.
Methods:
We enrolled children who underwent presurgical evaluation of refractory epilepsy with subdural grid electrodes. We analyzed electroencephalogram data from subdural electrodes and simultaneous recording with Cz scalp electrode. Sleep spindles, K-complexes, and vertex waves were identified and localized based on their morphology on the subdural electrodes.
Results:
Sixteen patients (9 boys; age range, 3-18 years) were enrolled in the study. The inter-rater reliability on identification and localization of maximal amplitude was high with an intraclass correlation coefficient of 0.85 for vertex waves, 0.94 for sleep spindles, and 0.91 for K-complexes. Sleep spindles presented maximum amplitude around the perirolandic area with a field extending to the frontal regions. K-complexes presented maximum amplitude around the perirolandic area with a field extending to the frontal regions. Vertex waves presented maximum amplitude around the perirolandic areas.
Conclusions:
In our series of pediatric patients, sleep spindles, K-complexes, and vertex waves were localized around the perirolandic area.
