The BEST Conceivable Way to Talk About Epilepsy Biomarkers

Gliske, S.; Stacey, William C.

doi:10.1177/15357597231159714

Cited by 2 publications

(2 citation statements)

References 6 publications

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“…In other words, the clinical standard of care—the SOZ—is not an ideal prognostic biomarker of surgical outcome. 9 This has led to the search for additional prognostic biomarkers of outcome. 10 , 11 Two promising biomarkers are high frequency oscillations (HFOs) 12-14 and network connectivity.…”

Section: Introductionmentioning

confidence: 99%

High frequency oscillation network dynamics predict outcome in non-palliative epilepsy surgery

Lin,

Smith,

Gliske

et al. 2023

Brain Communications

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High frequency oscillations (HFOs) are a promising biomarker of outcome in intractable epilepsy. Prior HFO work focused on counting HFOs on individual channels, and it is still unclear how to translate those results into clinical care. We show that HFOs arise as network discharges that have valuable properties as predictive biomarkers. Here, we develop a tool to predict patient outcome before surgical resection is performed, based upon only prospective information. In addition to determining HFO rate on every channel, we performed a correlational analysis to evaluate functional connectivity of HFOs in 28 patients with intracranial electrodes. We found that HFOs were often not solitary events on a single channel, but part of a local network discharge. Eigenvector and outcloseness centrality were used to rank channel importance within the connectivity network, then used to compare patient outcome by comparison with the Seizure Onset Zone or a proportion within the proposed resected channels (Critical Resection Percentage). Combining the knowledge of each patient’s Seizure Onset Zone resection plan along with our computed HFO network centralities and HFO rate, we develop a Naïve Bayes model that predicts outcome (Positive Predictive Value: 100%) better than predicting based upon fully resecting the Seizure Onset Zone (Positive Predictive Value: 71%). Surgical margins had a large effect on outcomes: non-palliative patients in whom most of the Seizure Onset Zone was resected (‘definitive surgery’, ≥ 80% resected) had predictable outcomes, whereas palliative surgeries (< 80% resected) were not predictable. These results suggest that the addition of network properties of HFOs is more accurate in predicting patient outcome than Seizure Onset Zone alone in patients with most of the Seizure Onset Zone removed and offer great promise for informing clinical decisions in surgery for refractory epilepsy.

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Section: Introductionmentioning

confidence: 99%

High frequency oscillation network dynamics predict outcome in non-palliative epilepsy surgery

Lin,

Smith,

Gliske

et al. 2023

Brain Communications

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“…Generally, the goal is to find the epileptogenic zone, which is defined as the minimal amount of tissue necessary to remove in a patient to achieve seizure freedom 3 . Since this is a rather theoretical concept, which cannot be validated, we will be talking about biomarkers prognosticating surgical outcomes 4 .…”

Section: Introductionmentioning

confidence: 99%

Interictal invasive very high-frequency oscillations in resting awake state and sleep

Revajová,

Trávníček,

Jurák

et al. 2023

Sci Rep

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Interictal very high-frequency oscillations (VHFOs, 500–2000 Hz) in a resting awake state seem to be, according to a precedent study of our team, a more specific predictor of a good outcome of the epilepsy surgery compared to traditional interictal high-frequency oscillations (HFOs, 80–500 Hz). In this study, we retested this hypothesis on a larger cohort of patients. In addition, we also collected patients' sleep data and hypothesized that the occurrence of VHFOs in sleep will be greater than in resting state. We recorded interictal invasive electroencephalographic (iEEG) oscillations in 104 patients with drug-resistant epilepsy in a resting state and in 35 patients during sleep. 21 patients in the rest study and 11 patients in the sleep study met the inclusion criteria (interictal HFOs and VHFOs present in iEEG recordings, a surgical intervention and a postoperative follow-up of at least 1 year) for further evaluation of iEEG data. In the rest study, patients with good postoperative outcomes had significantly higher ratio of resected contacts with VHFOs compared to HFOs. In sleep, VHFOs were more abundant than in rest and the percentage of resected contacts in patients with good and poor outcomes did not considerably differ in any type of oscillations. In conclusion, (1) our results confirm, in a larger patient cohort, our previous work about VHFOs being a specific predictor of the area which needs to be resected; and (2) that more frequent sleep VHFOs do not further improve the results.

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The BEST Conceivable Way to Talk About Epilepsy Biomarkers

Cited by 2 publications

References 6 publications

High frequency oscillation network dynamics predict outcome in non-palliative epilepsy surgery

High frequency oscillation network dynamics predict outcome in non-palliative epilepsy surgery

Interictal invasive very high-frequency oscillations in resting awake state and sleep

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