The morphology of high frequency oscillations (HFO) does not improve delineating the epileptogenic zone

Publication date: April 2016
Source:Clinical Neurophysiology, Volume 127, Issue 4
Author(s): Sergey Burnos, Birgit Frauscher, Rina Zelmann, Claire Haegelen, Johannes Sarnthein, Jean Gotman
ObjectiveWe hypothesized that high frequency oscillations (HFOs) with irregular amplitude and frequency more specifically reflect epileptogenicity than HFOs with stable amplitude and frequency.MethodsWe developed a fully automatic algorithm to detect HFOs and classify them based on their morphology, with types defined according to regularity in amplitude and frequency: type 1 with regular amplitude and frequency; type 2 with irregular amplitude, which could result from filtering of sharp spikes; type 3 with irregular frequency; and type 4 with irregular amplitude and frequency. We investigated the association of different HFO types with the seizure onset zone (SOZ), resected area and surgical outcome.ResultsHFO rates of all types were significantly higher inside the SOZ than outside. HFO types 1 and 2 were strongly correlated to each other and showed the highest rates among all HFOs. Their occurrence was highly associated with the SOZ, resected area and surgical outcome. The automatic detection emulated visual markings with 93% true positives and 57% false detections.ConclusionsHFO types 1 and 2 similarly reflect epileptogenicity.SignificanceFor clinical application, it may not be necessary to separate real HFOs from "false oscillations" produced by the filter effect of sharp spikes. Also for automatically detected HFOs, surgical outcome is better when locations with higher HFO rates are included in the resection.



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