Changes in epileptogenicity biomarkers after stereotactic thermocoagulation

Objective Stereo‐electroencephalography (SEEG)‐guided radiofrequency thermocoagulation (RF‐TC) aims at modifying epileptogenic networks to reduce seizure frequency. High‐frequency oscillations (HFOs), spikes, and cross‐rate are quantifiable epileptogenic biomarkers. In this study, we sought to evalu...

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Bibliographic Details
Published in:Epilepsia (Copenhagen) 2021-09, Vol.62 (9), p.2048-2059
Main Authors: Contento, Margherita, Pizzo, Francesca, López‐Madrona, Víctor J., Lagarde, Stanislas, Makhalova, Julia, Trébuchon, Agnes, Medina Villalon, Samuel, Giusiano, Bernard, Scavarda, Didier, Carron, Romain, Roehri, Nicolas, Bénar, Christian‐George, Bartolomei, Fabrice
Format: Article
Language:English
Subjects:
Biomarkers
EEG
Electrocoagulation
Electroencephalography
epileptogenic biomarkers
Firing rate
Human health and pathology
Humans
Imaging, Three-Dimensional
Life Sciences
Oscillations
Patients
Seizures
stereo‐electroencephalography
Surgery
thermocoagulation
Treatment Outcome
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Summary:Objective Stereo‐electroencephalography (SEEG)‐guided radiofrequency thermocoagulation (RF‐TC) aims at modifying epileptogenic networks to reduce seizure frequency. High‐frequency oscillations (HFOs), spikes, and cross‐rate are quantifiable epileptogenic biomarkers. In this study, we sought to evaluate, using SEEG signals recorded before and after thermocoagulation, whether a variation in these markers is related to the therapeutic effect of this procedure and to the outcome of surgery. Methods Interictal segments of SEEG signals were analyzed in 38 patients during presurgical evaluation. We used an automatized method to quantify the rate of spikes, rate of HFOs, and cross‐rate (a measure combining spikes and HFOs) before and after thermocoagulation. We analyzed the differences both at an individual level with a surrogate approach and at a group level with analysis of variance. We then evaluated the correlation between these variations and the clinical response to RF‐TC and to subsequent resective surgery. Results After thermocoagulation, 19 patients showed a clinical improvement. At the individual level, clinically improved patients more frequently had a reduction in spikes and cross‐rate in the epileptogenic zone than patients without clinical improvement (p = .002, p = .02). At a group level, there was a greater decrease of HFOs in epileptogenic and thermocoagulated zones in patients with clinical improvement (p 
ISSN:0013-9580
1528-1167
1528-1157
DOI:10.1111/epi.16989