Changes in epileptogenicity biomarkers after stereotactic thermocoagulation

Area of Science:

• Neurology
• Neurosurgery
• Biomarkers

Background:

• Stereo-electroencephalography (SEEG)-guided radiofrequency thermocoagulation (RF-TC) is a therapeutic approach for epilepsy.
• High-frequency oscillations (HFOs), spikes, and cross-rate are established biomarkers of epileptogenicity.
• Assessing changes in these biomarkers post-intervention is crucial for evaluating treatment efficacy.

Purpose of the Study:

• To investigate the relationship between changes in SEEG biomarkers and the clinical outcomes of RF-TC.
• To determine if biomarker variations predict the success of RF-TC and subsequent resective surgery.

Main Methods:

• Analysis of interictal SEEG signals from 38 epilepsy patients before and after RF-TC.
• Automated quantification of spikes, HFOs, and cross-rate using a validated method.
• Individual and group-level statistical analyses to assess biomarker changes and their correlation with clinical response.

Main Results:

• Clinically improved patients showed a significant reduction in spikes and cross-rate (individual level) and HFOs (group level) in the epileptogenic zone.
• A significant decrease in all quantified biomarkers was observed in patients with favorable outcomes after resective surgery.
• Biomarker reductions correlated with both RF-TC effectiveness and successful resective surgery outcomes.

Conclusions:

• Quantifiable changes in interictal biomarkers following RF-TC are associated with therapeutic success.
• These biomarker modifications can potentially predict the effectiveness of RF-TC and the outcome of resective epilepsy surgery.