High frequency oscillations (HFOs) are recognized as biomarkers for epileptogenic brain tissue. A remaining challenge for epilepsy surgery is the prospective classification of tissue sampled by individual electrode contacts. We analysed long-term invasive recordings of 20 consecutive patients who subsequently underwent epilepsy surgery. HFOs were defined prospectively by a previously validated, automated algorithm in the ripple (80–250 Hz) and the fast ripple (FR, 250–500 Hz) frequency band. Contacts with the highest rate of ripples co-occurring with FR over several five-minute time intervals designated the HFO area. The HFO area was fully included in the resected area in all 13 patients who achieved seizure freedom (specificity 100%) and in 3 patients where seizures reoccurred (negative predictive value 81%). The HFO area was only partially resected in 4 patients suffering from recurrent seizures (positive predictive value 100%, sensitivity 57%). Thus, the resection of the prospectively defined HFO area proved to be highly specific and reproducible in 13/13 patients with seizure freedom, while it may have improved the outcome in 4/7 patients with recurrent seizures. We thus validated the clinical relevance of the HFO area in the individual patient with an automated procedure. This is a prerequisite before HFOs can guide surgical treatment in multicentre studies.

The maintenance of items in working memory relies on persistent neural activity in a widespread network of brain areas. To investigate the influence of load on working memory, we asked human subjects to maintain sets of letters in memory while we recorded single neurons and intracranial encephalography (EEG) in the medial temporal lobe and scalp EEG. Along the periods of a trial, hippocampal neural firing differentiated between success and error trials during stimulus encoding, predicted workload during memory maintenance, and predicted the subjects’ behavior during retrieval. During maintenance, neuronal firing was synchronized with intracranial hippocampal EEG. On the network level, synchronization between hippocampal and scalp EEG in the theta-alpha frequency range showed workload dependent oscillatory coupling between hippocampus and cortex. Thus, we found that persistent neural activity in the hippocampus participated in working memory processing that is specific to memory maintenance, load sensitive and synchronized to the cortex.

ObjectivesHigh frequency oscillations (HFOs) have been proposed as a new biomarker for epileptogenic tissue. The exact characteristics of clinically relevant HFOs and their detection are still to be defined.MethodsWe propose a new method for HFO detection, which we have applied to six patient iEEGs. In a first stage, events of interest (EoIs) in the iEEG were defined by thresholds of energy and duration. To recognize HFOs among the EoIs, in a second stage the iEEG was Stockwell-transformed into the time-frequency domain, and the instantaneous power spectrum was parameterized. The parameters were optimized for HFO detection in patient 1 and tested in patients 2–5. Channels were ranked by HFO rate and those with rate above half maximum constituted the HFO area. The seizure onset zone (SOZ) served as gold standard.ResultsThe detector distinguished HFOs from artifacts and other EEG activity such as interictal epileptiform spikes. Computation took few minutes. We found HFOs with relevant power at frequencies also below the 80–500 Hz band, which is conventionally associated with HFOs. The HFO area overlapped with the SOZ with good specificity > 90% for five patients and one patient was re-operated. The performance of the detector was compared to two well-known detectors.ConclusionsCompared to methods detecting energy changes in filtered signals, our second stage - analysis in the time-frequency domain - discards spurious detections caused by artifacts or sharp epileptic activity and improves the detection of HFOs. The fast computation and reasonable accuracy hold promise for the diagnostic value of the detector.

No abstract

An example script is provided with the dataset. It contains code snippets for reading and plotting the data and information related to the subjects and the task. All code is implemented in MATLAB (Mathworks Inc., version R2016B on Windows).