@article{229da716cf884689a2e87d9c9006cb82,
title = "Prospective observational study: Fast ripple localization delineates the epileptogenic zone",
abstract = "Objective: To investigate spatial correlation between interictal HFOs and neuroimaging abnormalities, and to determine if complete removal of prospectively identified interictal HFOs correlates with post-surgical seizure-freedom. Methods: Interictal fast ripples (FRs: 250–500 Hz) in 19 consecutive children with pharmacoresistant focal epilepsy who underwent extra-operative electrocorticography (ECoG) recording were prospectively analyzed. The interictal FRs were sampled at 2000 Hz and were visually identified during 10 min of slow wave sleep. Interictal FRs, MRI and FDG-PET were delineated on patient-specific reconstructed three-dimensional brain MRI. Results: Interictal FRs were observed in all patients except one. Thirteen out of 18 patients (72%) exhibited FRs beyond the extent of neuroimaging abnormalities. Fifteen of 19 children underwent resective surgery, and survival analysis with log-rank test demonstrated that complete resection of cortical sites showing interictal FRs correlated with longer post-operative seizure-freedom (p < 0.01). Complete resection of seizure onset zones (SOZ) also correlated with longer post-operative seizure-freedom (p = 0.01), yet complete resection of neuroimaging abnormalities did not (p = 0.43). Conclusions: Prospective visual analysis of interictal FRs was feasible, and it seemed to accurately localize epileptogenic zones. Significance: Topological extent of epileptogenic region may exceed what is discernible by multimodal neuroimaging.",
keywords = "Epilepsy surgery, FR, HFO, High frequency oscillations, Ripple",
author = "Hiroki Nariai and Hussain, {Shaun A.} and Danilo Bernardo and Aria Fallah and Murata, {Kristina K.} and Nguyen, {Jimmy C.} and Rajaraman, {Rajsekar R.} and Rao, {Lekha M.} and Matsumoto, {Joyce H.} and Lerner, {Jason T.} and Noriko Salamon and David Elashoff and Raman Sankar and Wu, {Joyce Y.}",
note = "Funding Information: HN is supported by Susan Spencer Clinical Research Training Fellowship in Epilepsy from the American Academy of Neurology , with funding from the American Epilepsy Society, the American Brain Foundation, and the Epilepsy Foundation. RR as well as HN have received research support from the Pediatric Victory Foundation. SAH has received research support from the Epilepsy Therapy Project, the Milken Family Foundation, the Hughes Family Foundation, the Elsie and Isaac Fogelman Endowment, Eisai, Lundbeck, Insys, Zogenix, GW Pharmaceuticals, UCB, and the NIH ( R34MH089299 ), and has received honoraria for service on the scientific advisory boards of Questcor, Mallinckrodt, Insys, UCB, and Upsher-Smith, for service as a consultant to Eisai, UCB, GW pharmaceuticals, Insys, and Mallinckrodt, and for service on the speakers{\textquoteright} bureaus of Mallinckrodt and Greenwich Bioscience. RS serves on scientific advisory boards and speakers bureaus for and has received honoraria and funding for travel from Eisai, Greenwich Biosciences, UCB Pharma, Sunovion, Supernus, Lundbeck Pharma, Liva Nova, and West Therapeutics (advisory only); receives royalties from the publication of Pellock{\textquoteright}s Pediatric Neurology (Demos Publishing, 2016) and Epilepsy: Mechanisms, Models, and Translational Perspectives (CRC Press, 2011). JYW has received research funding from Novartis, GW Pharmaceutical, NINDS/NIH ( R01 NS082649 , U01 NS082320 , U54 NS092090 , U01 NS092595 ), and the Today{\textquoteright}s and Tomorrow{\textquoteright}s Children Fund from UCLA Mattel Children{\textquoteright}s Hospital at the University of California Los Angeles. Funding Information: The research described was also supported by NIH/National Center for Advancing Translational Science ( NCATS ) UCLA CTSI Grant Number UL1TR001881 . Funding Information: HN is supported by Susan Spencer Clinical Research Training Fellowship in Epilepsy from the American Academy of Neurology, with funding from the American Epilepsy Society, the American Brain Foundation, and the Epilepsy Foundation. RR as well as HN have received research support from the Pediatric Victory Foundation. SAH has received research support from the Epilepsy Therapy Project, the Milken Family Foundation, the Hughes Family Foundation, the Elsie and Isaac Fogelman Endowment, Eisai, Lundbeck, Insys, Zogenix, GW Pharmaceuticals, UCB, and the NIH (R34MH089299), and has received honoraria for service on the scientific advisory boards of Questcor, Mallinckrodt, Insys, UCB, and Upsher-Smith, for service as a consultant to Eisai, UCB, GW pharmaceuticals, Insys, and Mallinckrodt, and for service on the speakers? bureaus of Mallinckrodt and Greenwich Bioscience. RS serves on scientific advisory boards and speakers bureaus for and has received honoraria and funding for travel from Eisai, Greenwich Biosciences, UCB Pharma, Sunovion, Supernus, Lundbeck Pharma, Liva Nova, and West Therapeutics (advisory only); receives royalties from the publication of Pellock's Pediatric Neurology (Demos Publishing, 2016) and Epilepsy: Mechanisms, Models, and Translational Perspectives (CRC Press, 2011). JYW has received research funding from Novartis, GW Pharmaceutical, NINDS/NIH (R01 NS082649, U01 NS082320, U54 NS092090, U01 NS092595), and the Today's and Tomorrow's Children Fund from UCLA Mattel Children's Hospital at the University of California Los Angeles. The research described was also supported by NIH/National Center for Advancing Translational Science (NCATS) UCLA CTSI Grant Number UL1TR001881. We are indebted to Conrad Szeliga, Maria Garcia Roca, Richard Le, Patrick Wilson, and Divya Nadkarni for their assistance in study and sample acquisition. Publisher Copyright: {\textcopyright} 2019 International Federation of Clinical Neurophysiology",
year = "2019",
month = nov,
doi = "10.1016/j.clinph.2019.08.026",
language = "English (US)",
volume = "130",
pages = "2144--2152",
journal = "Clinical Neurophysiology",
issn = "1388-2457",
publisher = "Elsevier Ireland Ltd",
number = "11",
}