Abstract

Accurately identifying epileptogenic zone (EZ) using high-frequency oscillations (HFOs) is a challenge that must be mastered to transfer HFOs into clinical use. We analyzed the ability of a convolutional neural network (CNN) model to distinguish EZ and non-EZ HFOs. Nineteen medically intractable epilepsy patients with good surgical outcomes 2 years after surgery were studied. Five-minute interictal intracranial electroencephalogram epochs of slow-wave sleep were selected randomly. Then 5 s segments of ripples (80–200 Hz) and fast ripples (FRs, 200–500 Hz) were detected automatically. The EZs and non-EZs were identified using the surgery resection range. We innovatively converted all epochs into four types of images using two scales: original waveforms, filtered waveforms, wavelet spectrum images, and smoothed pseudo Wigner–Ville distribution (SPWVD) spectrum images. Two scales were fixed and fitted scales. We then used a CNN model to classify the HFOs into EZ and non-EZ categories. As a result, 7,000 epochs of ripples and 2,000 epochs of FRs were randomly selected from the EZ and non-EZ data for analysis. Our CNN model can distinguish EZ and non-EZ HFOs successfully. Except for original ripple waveforms, the results from CNN models that are trained using fixed-scale images are significantly better than those from models trained using fitted-scale images (p < 0.05). Of the four fixed-scale transformations, the CNN based on the adjusted SPWVD (ASPWVD) produced the best accuracies (80.89 ± 1.43% and 77.85 ± 1.61% for ripples and FRs, respectively, p < 0.05). The CNN using ASPWVD transformation images is an effective deep learning method that can be used to classify EZ and non-EZ HFOs.

Highlights

  • Pathological high frequency oscillations (HFOs) have been proposed as a promising biomarker for the epileptogenic zone (EZ) [1]

  • The patient inclusion criteria consisted of the following: [1] intractable epilepsy patients that were addressed via EZ removal surgery at the Epilepsy Centre of Beijing Haidian Hospital between January 2013 and December 2015; [2] implantation of subdural grids or depth electrodes followed by intracranial EEG monitoring with video at a sampling rate of 2,000 Hz for at least one entire night; and [3] at least 2 years of patient follow-up after surgery to confirm an Engel I surgical outcome

  • A total of 19 subjects with focal refractory epilepsy were included in the study (10 females)

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Summary

Introduction

Pathological high frequency oscillations (HFOs) have been proposed as a promising biomarker for the epileptogenic zone (EZ) [1]. They are defined as four continuous oscillations within the 80–500 Hz range whose amplitudes are significantly higher than the baseline. Resection of areas with high HFO occurrence ratios is associated with good surgical outcomes [3]. FRs outside the EZ disappear concurrently after resection of FRs inside the EZ in patients with good surgical outcomes. This indicates the presence of an epileptogenic network [11]. Subsequent studies focus on further development of novel methods to classify EZ and non-EZ HFOs to delineate the EZ range accurately

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