Interrater reliability in visual identification of interictal high-frequency oscillations on electrocorticography and scalp EEG

Hiroki Nariai, Joyce Y. Wu*, Danilo Bernardo, Aria Fallah, Raman Sankar, Shaun A. Hussain

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

High-frequency oscillations (HFOs), including ripples (Rs) and fast ripples (FRs), are promising biomarkers of epileptogenesis, but their clinical utility is limited by the lack of a standardized approach to identification. We set out to determine whether electroencephalographers experienced in HFO analysis can reliably identify and quantify interictal HFOs. Two blinded raters independently reviewed 10 intraoperative electrocorticography (ECoG) samples from epilepsy surgery cases, and 10 scalp EEG samples from epilepsy monitoring unit evaluations. HFOs were visually marked using bandpass filters (R, 80–250 Hz; FR, 250–500 Hz) with a sampling frequency of 2,000 Hz. There was agreement as to the presence or absence of epileptiform discharges (EDs), Rs, and FRs, in 17, 18, and 18 cases, respectively. Interrater reliability (IRR) was favorable with κ = 0.70, 0.80, and 0.80, respectively, and similar for ECoG and scalp electroencephalography (EEG). Furthermore, interclass correlation for rates of Rs (0.99, 95% confidence interval [CI] 0.96–0.99) and FRs (0.77, 95% CI 0.41–0.91) were superior in comparison to EDs (0.37, 95% CI −0.60 to 0.75). Our data suggest that HFO identification and quantification are reliable among experienced electroencephalographers. Our findings support the reliability of utilizing HFO data in both research and clinical arenas.

Original languageEnglish (US)
Pages (from-to)127-132
Number of pages6
JournalEpilepsia Open
Volume3
Issue numberS2
DOIs
StatePublished - Dec 2018

Keywords

  • Fast ripple
  • High-frequency oscillation
  • Interrater reliability
  • Ripple

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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