Interictal high-frequency oscillations in focal human epilepsy
Jan Cimbalnik1, Michal T Kucewicz, Greg Worrell
1aMayo Systems Electrophysiology Laboratory, Department of NeurologybDepartment of Biomedical Engineering and Physiology, Mayo Clinic, Rochester, Minnesota, USAcInternational Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic.
Current Opinion in Neurology
|March 9, 2016
Summary
High-frequency oscillations (HFOs) show promise for identifying epileptic brain regions, but challenges remain in distinguishing them from normal brain activity for clinical use.
Area of Science:
- Neuroscience
- Clinical Neurology
- Biomarker Research
Background:
- Accurate localization of focal epileptic brain areas is crucial for effective epilepsy surgery and brain stimulation.
- Current surgical and stimulation methods achieve seizure freedom in only about half of patients, highlighting the need for improved biomarkers.
- High-frequency oscillations (HFOs) recorded via intracranial electroencephalography are being investigated as potential biomarkers for better localization.
Purpose of the Study:
- To review the evidence supporting the clinical utility of HFOs as biomarkers for localizing focal epileptic brain regions.
- To assess the potential of HFOs in improving outcomes for epilepsy surgery and focal electrical stimulation.
- To identify challenges hindering the clinical translation of HFOs.
Main Methods:
- A PubMed search for 'High-Frequency Oscillations and Epilepsy' was conducted for articles published between 2013 and 2015.
- The review examined 308 articles focusing on HFO characteristics, physiological significance, and clinical applications.
- Evidence for the clinical usefulness of HFOs as biomarkers was critically evaluated.
Main Results:
- The search identified a substantial body of literature (308 articles) on HFOs in epilepsy from 2013-2015.
- Strong spatial associations between HFOs and epileptic brain tissue have been demonstrated.
- Significant challenges persist in differentiating pathological HFOs from physiological activity and artifacts.
Conclusions:
- HFOs are spatially linked to epileptic brain tissue, suggesting their potential as biomarkers.
- Key challenges include differentiating true HFOs from neuronal firing artifacts, distinguishing pathological from physiological HFOs, and classifying tissue status.
- Further research, including data sharing, algorithm development, and multicenter prospective trials, is necessary for clinical validation and application.
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