Localization of the Epileptogenic Zone Using High Frequency Oscillations
Aljoscha Thomschewski1,2, Ana-Sofía Hincapié3, Birgit Frauscher3
1Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg, Austria.
Frontiers in Neurology
|February 27, 2019
Summary
High-frequency oscillations (HFOs) show promise as a biomarker for epilepsy surgery, potentially improving outcomes. Further research is needed to validate their clinical use, differentiate them from physiologic signals, and enable non-invasive scalp recordings.
Area of Science:
- Neuroscience
- Epileptology
- Biomarker Research
Background:
- Drug-resistant focal epilepsy necessitates surgery for seizure freedom.
- Current seizure-onset zone (SOZ) identification has suboptimal surgical outcomes (40-50%).
- High-frequency oscillations (HFOs) are emerging as potential biomarkers for the epileptogenic zone (EZ).
Purpose of the Study:
- To review the literature on HFOs as a biomarker for localizing the epileptogenic zone (EZ).
- To address key challenges in establishing HFOs for clinical use in epilepsy surgery planning.
- To explore the potential of non-invasive HFO recordings for broader clinical application.
Main Methods:
- Literature review focusing on invasively recorded HFOs for EZ localization.
- Examination of HFO detection methods and differentiation from physiologic signals.
- Review of current literature on non-invasively recorded HFOs using EEG and MEG.
Main Results:
- Invasive HFOs show promise but require prospective validation and automatic detection for reliability.
- Distinguishing pathologic from physiologic HFOs remains a challenge for accurate interpretation.
- Non-invasive scalp recordings (EEG/MEG) of HFOs are desirable for wider patient applicability.
Conclusions:
- HFOs represent a promising biomarker for improving epilepsy surgery outcomes.
- Further research is crucial for prospective validation, reliable detection, and clinical translation of HFOs.
- Developing non-invasive HFO recording techniques is essential for widespread clinical adoption.
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