Phase-amplitude coupling between low- and high-frequency activities as preoperative biomarker of focal cortical dysplasia subtypes

•Ictal phase-amplitude coupling (PAC) between high-frequency and low-frequency activity can be used as a preoperative biomarker of focal cortical dysplasia (FCD) subtypes.•Ictal PAC was significantly higher in patients with FCD type II compared to type I, only on the electrodes of the seizure-onset...

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Published in:Clinical neurophysiology 2023-06, Vol.150, p.40-48
Main Authors: Ricci, Lorenzo, Tamilia, Eleonora, Mercier, Mattia, Pepi, Chiara, Carfì-Pavia, Giusy, De Benedictis, Alessandro, Assenza, Giovanni, Di Lazzaro, Vincenzo, Vigevano, Federico, Specchio, Nicola, de Palma, Luca
Format: Article
Language:English
Subjects:
Biomarkers
Child
Electroencephalography
Epilepsy - surgery
Focal Cortical Dysplasia
Humans
Magnetic Resonance Imaging
Malformations of Cortical Development - diagnosis
Malformations of Cortical Development - pathology
Malformations of Cortical Development - surgery
Phase-amplitude coupling
Retrospective Studies
Seizures
Stereo-EEG
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Summary:•Ictal phase-amplitude coupling (PAC) between high-frequency and low-frequency activity can be used as a preoperative biomarker of focal cortical dysplasia (FCD) subtypes.•Ictal PAC was significantly higher in patients with FCD type II compared to type I, only on the electrodes of the seizure-onset zone (SOZ).•Ictal PAC applied to SOZ-electrodes during stereo-EEG offers a high predictive value of FCD histopathology. To evaluate whether ictal phase-amplitude coupling (PAC) between high-frequency activity and low-frequency activity could be used as a preoperative biomarker of Focal Cortical Dysplasia (FCD) subtypes. We hypothesize that FCD seizures present unique PAC characteristics that may be linked to their specific histopathological features. We retrospectively examined 12 children with FCD and refractory epilepsy who underwent successful epilepsy surgery. We identified ictal onsets recorded with stereo-EEG. We estimated the strength of PAC between low-frequencies and high-frequencies for each seizure by means of modulation index. Generalized mixed effect models and receiver operating characteristic (ROC) curve analysis were used to test the association between ictal PAC and FCD subtypes. Ictal PAC was significantly higher in patients with FCD type II compared to type I, only on SOZ-electrodes (p  0.9 (p 
ISSN:1388-2457
1872-8952
1872-8952
DOI:10.1016/j.clinph.2023.03.006