Scalp high-frequency oscillation spatial distribution is consistent over consecutive nights, while rates vary with...

Area of Science:

• Neuroscience
• Clinical Neurology
• Biomedical Engineering

Background:

• Pediatric focal lesional epilepsy presents diagnostic and therapeutic challenges.
• Scalp high-frequency oscillations (HFOs) are potential biomarkers for identifying epileptogenic zones.
• Understanding HFO stability and responsiveness to treatment is crucial for clinical application.

Purpose of the Study:

• To assess the inter-night stability of scalp HFO spatial distribution in children with focal lesional epilepsy.
• To investigate the impact of changes in antiseizure medication (ASM) dosage on scalp HFO rates.

Main Methods:

• Analysis of 81 whole-night scalp electroencephalography (EEG) recordings from 20 pediatric patients.
• Utilized an automated HFO detector to quantify HFO rates (80-250 Hz) during non-rapid eye movement (NREM) sleep.
• Assessed HFO spatial distribution stability using Hamming similarity and correlated HFO rates with ASM dosage changes.

Main Results:

• Scalp HFO distribution demonstrated high stability across consecutive nights (88% ± 6% Hamming similarity).
• Decreased ASM dosage correlated with increased HFO rates (p=0.03).
• Increased ASM dosage correlated with decreased HFO rates (p=0.005).

Conclusions:

• Scalp HFO spatial patterns are consistent over multiple nights in pediatric focal lesional epilepsy.
• Fluctuations in scalp HFO rates are directly related to adjustments in antiseizure medication.
• Scalp HFOs show promise as a tool for both localizing epilepsy and monitoring treatment response.