Phase‐amplitude coupling between interictal high‐frequency activity and slow waves in epilepsy surgery

Objective We hypothesized that the modulation index (MI), a summary measure of the strength of phase‐amplitude coupling between high‐frequency activity (>150 Hz) and the phase of slow waves (3‐4 Hz), would serve as a useful interictal biomarker for epilepsy presurgical evaluation. Methods We inve...

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Published in:Epilepsia (Copenhagen) 2018-10, Vol.59 (10), p.1954-1965
Main Authors: Motoi, Hirotaka, Miyakoshi, Makoto, Abel, Taylor J., Jeong, Jeong‐Won, Nakai, Yasuo, Sugiura, Ayaka, Luat, Aimee F., Agarwal, Rajkumar, Sood, Sandeep, Asano, Eishi
Format: Article
Language:English
Subjects:
Adolescent
Adult
Brain Mapping
Brain Waves - physiology
Child
Child, Preschool
Electroencephalography
Epilepsy - diagnostic imaging
Epilepsy - physiopathology
Epilepsy - surgery
epileptogenic zone
Female
high‐frequency oscillations
Humans
Image Processing, Computer-Assisted
invasive recording
irritative zone
Logistic Models
Magnetic Resonance Imaging
Male
Retrospective Studies
ROC Curve
Sleep - physiology
Treatment Outcome
video‐EEG monitoring
Young Adult
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Summary:Objective We hypothesized that the modulation index (MI), a summary measure of the strength of phase‐amplitude coupling between high‐frequency activity (>150 Hz) and the phase of slow waves (3‐4 Hz), would serve as a useful interictal biomarker for epilepsy presurgical evaluation. Methods We investigated 123 patients who underwent focal cortical resection following extraoperative electrocorticography recording and had at least 1 year of postoperative follow‐up. We examined whether consideration of MI would improve the prediction of postoperative seizure outcome. MI was measured at each intracranial electrode site during interictal slow‐wave sleep. We compared the accuracy of prediction of patients achieving International League Against Epilepsy class 1 outcome between the full multivariate logistic regression model incorporating MI in addition to conventional clinical, seizure onset zone (SOZ), and neuroimaging variables, and the reduced logistic regression model incorporating all variables other than MI. Results Ninety patients had class 1 outcome at the time of most recent follow‐up (mean follow‐up = 5.7 years). The full model had a noteworthy outcome predictive ability, as reflected by regression model fit R2 of 0.409 and area under the curve (AUC) of receiver operating characteristic plot of 0.838. Incomplete resection of SOZ (P 
ISSN:0013-9580
1528-1167
DOI:10.1111/epi.14544