Temporal changes of neocortical high-frequency oscillations in epilepsy.

ABSTRACT

High-frequency (100-500 Hz) oscillations (HFOs) recorded from intracranial electrodes are a potential biomarker for epileptogenic brain. HFOs are commonly categorized as ripples (100-250 Hz) or fast ripples (250-500 Hz), and a third class of mixed frequency events has also been identified. We hypothesize that temporal changes in HFOs may identify periods of increased the likelihood of seizure onset. HFOs (86,151) from five patients with neocortical epilepsy implanted with hybrid (micro + macro) intracranial electrodes were detected using a previously validated automated algorithm run over all channels of each patient's entire recording. HFOs were characterized by extracting quantitative morphologic features and divided into four time epochs (interictal, preictal, ictal, and postictal) and three HFO clusters (ripples, fast ripples, and mixed events). We used supervised classification and nonparametric statistical tests to explore quantitative changes in HFO features before, during, and after seizures. We also analyzed temporal changes in the rates and proportions of events from each HFO cluster during these periods. We observed patient-specific changes in HFO morphology linked to fluctuation in the relative rates of ripples, fast ripples, and mixed frequency events. These changes in relative rate occurred in pre- and postictal periods up to thirty min before and after seizures. We also found evidence that the distribution of HFOs during these different time periods varied greatly between individual patients. These results suggest that temporal analysis of HFO features has potential for designing custom seizure prediction algorithms and for exploring the relationship between HFOs and seizure generation.