Ripple Band Research Articles

The appearance of scalp high-frequency oscillations is associated with poor seizure control in pediatric epilepsy patients.

Epilepsy treatment with anti-seizure medications (ASMs) is based on careful assessment of the balance between the likelihood of further seizures and the risk of side effects of treatment. However, there is currently no established biomarker to ascertain seizure control status with ASMs. High-frequency oscillations (HFOs), transient bursts of EEG activity with frequencies beyond 80 Hz, are a new and promising noninvasive epilepsy biomarker. We compared the risk of scalp HFO appearance between pediatric patients with good and poor seizure control by treatment with ASMs. A total of 72 epilepsy patients (aged 0-18 years, 39 males) with good and poor seizure control with ASMs participated in this study. We applied a validated automated detector to determine HFO and spike. We calculated the odds ratios (ORs) for scalp HFO and spike appearance according to seizure control status by multiple logistic regression analysis. Scalp HFO was seen more commonly and with a significantly higher detection rate in patients with poor seizure control as compared with patients with good seizure control for both ripple and fast ripple. These significant associations were found for both focal and generalized epilepsy. The ORs for scalp HFO appearance adjusted for confounding factors were significantly higher in patients with poor seizure control compared to those with good seizure control (ripple: OR [95% CI] = 11.91 [2.21-64.30], p = 0.004; fast ripple: 4.98 [1.03-24.09], p = 0.046). There were no significant associations between spike appearance and seizure control status. We found an increased risk of scalp HFO appearance in patients with poor seizure control. The results of this study support that scalp HFO is associated with patients having frequent seizures after treatment in both ripple and fast ripple. This study analyzed scalp high-frequency oscillations and spikes in pediatric patients with various types of epilepsy who were being treated using ASMs. The results showed that an increased risk of scalp HFO appearance was observed in patients with poor seizure control compared to those with good seizure control. These findings were observed in both the ripple (80-250 Hz) and fast ripple (250-500 Hz) bands. The scalp HFO is associated with patients having frequent seizures after treatment in both ripple and fast ripple.

Self-Supervised Data-Driven Approach Defines Pathological High-Frequency Oscillations in Human.

Interictal high-frequency oscillations (HFOs) are a promising neurophysiological biomarker of the epileptogenic zone (EZ). However, objective criteria for distinguishing pathological from physiological HFOs remain elusive, hindering clinical application. We investigated whether the distinct mechanisms underlying pathological and physiological HFOs are encapsulated in their signal morphology in intracranial EEG (iEEG) recordings and whether this mechanism-driven distinction could be simulated by a deep generative model. In a retrospective cohort of 185 epilepsy patients who underwent iEEG monitoring, we analyzed 686,410 HFOs across 18,265 brain contacts. To learn morphological characteristics, each event was transformed into a time-frequency plot and input into a variational autoencoder. We characterized latent space clusters containing morphologically defined putative pathological HFOs (mpHFOs) using interpretability analysis, including latent space disentanglement and time-domain perturbation. mpHFOs showed strong associations with expert-defined spikes and were predominantly located within the seizure onset zone (SOZ). Discovered novel pathological features included high power in the gamma (30-80 Hz) and ripple (>80 Hz) bands centered on the event. These characteristics were consistent across multiple variables, including institution, electrode type, and patient demographics. Predicting 12-month postoperative seizure outcomes using the resection ratio of mpHFOs outperformed unclassified HFOs (F1=0.72 vs. 0.68) and matched current clinical standards using SOZ resection (F1=0.74). Combining mpHFO data with demographic and SOZ resection status further improved prediction accuracy (F1=0.83). Our data-driven approach yielded a novel, explainable definition of pathological HFOs, which has the potential to further enhance the clinical use of HFOs for EZ delineation.

Connectivity of high-frequency bursts as SOZ localization biomarker.

For patients with refractory epilepsy, the seizure onset zone (SOZ) plays an essential role in determining the specific regions of the brain that will be surgically resected. High-frequency oscillations (HFOs) and connectivity-based approaches have been identified among the potential biomarkers to localize the SOZ. However, there is no consensus on how connectivity between HFO events should be estimated, nor on its subject-specific short-term reliability. Therefore, we propose the channel-level connectivity dispersion (CLCD) as a metric to quantify the variability in synchronization between individual electrodes and to identify clusters of electrodes with abnormal synchronization, which we hypothesize to be associated with the SOZ. In addition, we developed a specialized filtering method that reduces oscillatory components caused by filtering broadband artifacts, such as sharp transients, spikes, or direct current shifts. Our connectivity estimates are therefore robust to the presence of these waveforms. To calculate our metric, we start by creating binary signals indicating the presence of high-frequency bursts in each channel, from which we calculate the pairwise connectivity between channels. Then, the CLCD is calculated by combining the connectivity matrices and measuring the variability in each electrode's combined connectivity values. We test our method using two independent open-access datasets comprising intracranial electroencephalography signals from 89 to 15 patients with refractory epilepsy, respectively. Recordings in these datasets were sampled at approximately 1000Hz, and our proposed CLCDs were estimated in the ripple band (80-200Hz). Across all patients in the first dataset, the average ROC-AUC was 0.73, and the average Cohen's d was 1.05, while in the second dataset, the average ROC-AUC was 0.78 and Cohen's d was 1.07. On average, SOZ channels had lower CLCD values than non-SOZ channels. Furthermore, based on the second dataset, which includes surgical outcomes (Engel I-IV), our analysis suggested that higher CLCD interquartile (as a measure of CLCD distribution spread) is associated with favorable outcomes (Engel I). This suggests that CLCD could significantly assist in identifying SOZ clusters and, therefore, provide an additional tool in surgical planning for epilepsy patients.

Machine learning-based classification of physiological and pathological high-frequency oscillations recorded by stereoelectroencephalography

ObjectiveHigh-frequency oscillations (HFOs) are an efficient indicator to locate the epileptogenic zone (EZ). However, physiological HFOs produced in the normal brain region may interfere with EZ localization. The present study aimed to build a machine learning-based classifier to distinguish the properties of each HFO event based on features in different domains. MethodsHFOs were detected in focal epilepsy patients from two different hospitals who underwent stereoelectroencephalography and subsequent resection surgery. Subsequently, 37 features in four different domains (time, frequency and time-frequency, entropy-based and nonlinear) were extracted for each HFO. After extraction, a fast correlation-based filter (FCBF) algorithm was applied for feature selection. The machine learning classifier was trained on the feature matrix with and without FCBF and then tested on the data set from patients in another hospital. ResultsA dataset was compiled, consisting of 89,844 pathological HFOs and 23,613 physiological HFOs from 17 patients assigned to the training dataset. Additionally, 12,695 pathological HFOs and 5,599 physiological HFOs from 9 patients were assigned to the testing dataset. Four features (ripple band power, arithmetic mean, Petrosian fractal dimension and zero crossings) were obtained for classifier training after FCBF. The classifier showed an area under the curve (AUC) of 0.95/0.98 for FCBF/no FCBF features in the training dataset and AUC of 0.82/0.90 for FCBF/no FCBF features in the testing dataset. Our findings indicated that the classifier utilizing all features demonstrated superior performance compared to the one relying on FCBF-processed features. ConclusionOur classifier could reliably differentiate pathological HFOs from physiological ones, which could promote the development of HFOs in EZ localization.

EEG-based spatiotemporal dynamics of fast ripple networks and hubs in infantile epileptic spasms.

Infantile epileptic spasms (IS) are epileptic seizures that are associated with increased risk for developmental impairments, adult epilepsies, and mortality. Here, we investigated coherence-based network dynamics in scalp EEG of infants with IS to identify frequency-dependent networks associated with spasms. We hypothesized that there is a network of increased fast ripple connectivity during the electrographic onset of clinical spasms, which is distinct from controls. We retrospectively analyzed peri-ictal and interictal EEG recordings of 14 IS patients. The data was compared with 9 age-matched controls. Wavelet phase coherence (WPC) was computed between 0.2 and 400 Hz. Frequency- and time-dependent brain networks were constructed using this coherence as the strength of connection between two EEG channels, based on graph theory principles. Connectivity was evaluated through global efficiency (GE) and channel-based closeness centrality (CC), over frequency and time. GE in the fast ripple band (251-400 Hz) was significantly greater following the onset of spasms in all patients (P < 0.05). Fast ripple networks during the first 10s from spasm onset show enhanced anteroposterior gradient in connectivity (posterior > central > anterior, Kruskal-Wallis P < 0.001), with maximum CC over the centroparietal channels in 10/14 patients. Additionally, this anteroposterior gradient in CC connectivity is observed during spasms but not during the interictal awake or asleep states of infants with IS. In controls, anteroposterior gradient in fast ripple CC was noted during arousals and wakefulness but not during sleep. There was also a simultaneous decrease in GE in the 5-8 Hz range after the onset of spasms (P < 0.05), of unclear biological significance. We identified an anteroposterior gradient in the CC connectivity of fast ripple hubs during spasms. This anteroposterior gradient observed during spasms is similar to the anteroposterior gradient in the CC connectivity observed in wakefulness or arousals in controls, suggesting that this state change is related to arousal networks.

Connectivity alteration in thalamic nuclei and default mode network-related area in memory processes in mesial temporal lobe epilepsy using magnetoencephalography

This work aimed to investigate the involvement of the thalamic nuclei in mesial temporal lobe epilepsy (MTLE) and identify the influence of interictal epileptic discharges on the neural basis of memory processing by evaluating the functional connectivity (FC) between the thalamic nuclei and default mode network-related area (DMNRA) using magnetoencephalography. Preoperative datasets of nine patients with MTLE with seizure-free status after surgery and those of nine healthy controls were analyzed. The FC between the thalamic nuclei (anterior nucleus [ANT], mediodorsal nucleus [MD], intralaminar nuclei [IL]), hippocampus, and DMNRA was examined for each of the resting, pre-spike, spike, and post-spike periods in the delta to ripple bands using magnetoencephalography. The FC between the ANT, MD, hippocampus, and medial prefrontal cortex increased in the gamma to ripple bands, whereas the FC between the ANT, IL, and DMNRA decreased in the delta to beta bands, compared with that of the healthy controls at rest. Compared with the rest period, the pre-spike period had significantly decreased FC between the ANT, MD, and DMNRA in the ripple band. Different FC changes between the thalamic nuclei, hippocampus, and DMNRA of specific connections in a particular band may reflect impairment or compensation in the memory processes.

Phase-Amplitude Coupling Localizes Pathologic Brain with Aid of Behavioral Staging in Sleep.

Low frequency brain rhythms facilitate communication across large spatial regions in the brain and high frequency rhythms are thought to signify local processing among nearby assemblies. A heavily investigated mode by which these low frequency and high frequency phenomenon interact is phase-amplitude coupling (PAC). This phenomenon has recently shown promise as a novel electrophysiologic biomarker, in a number of neurologic diseases including human epilepsy. In 17 medically refractory epilepsy patients undergoing phase-2 monitoring for the evaluation of surgical resection and in whom temporal depth electrodes were implanted, we investigated the electrophysiologic relationships of PAC in epileptogenic (seizure onset zone or SOZ) and non-epileptogenic tissue (non-SOZ). That this biomarker can differentiate seizure onset zone from non-seizure onset zone has been established with ictal and pre-ictal data, but less so with interictal data. Here we show that this biomarker can differentiate SOZ from non-SOZ interictally and is also a function of interictal epileptiform discharges. We also show a differential level of PAC in slow-wave-sleep relative to NREM1-2 and awake states. Lastly, we show AUROC evaluation of the localization of SOZ is optimal when utilizing beta or alpha phase onto high-gamma or ripple band. The results suggest an elevated PAC may reflect an electrophysiology-based biomarker for abnormal/epileptogenic brain regions.

N°33 – Intracranial HFOs in the ripple band correlate with histopathology in focal cortical dysplasia

N°33 – Intracranial HFOs in the ripple band correlate with histopathology in focal cortical dysplasia

Relative entropy is an easy-to-use invasive electroencephalographic biomarker of the epileptogenic zone.

High-frequency oscillations are considered among the most promising interictal biomarkers of the epileptogenic zone in patients suffering from pharmacoresistant focal epilepsy. However, there is no clear definition of pathological high-frequency oscillations, and the existing detectors vary in methodology, performance, and computational costs. This study proposes relative entropy as an easy-to-use novel interictal biomarker of the epileptic tissue. We evaluated relative entropy and high-frequency oscillation biomarkers on intracranial electroencephalographic data from 39 patients with seizure-free postoperative outcome (Engel Ia) from three institutions. We tested their capability to localize the epileptogenic zone, defined as resected contacts located in the seizure onset zone. The performance was compared using areas under the receiver operating curves (AUROCs) and precision-recall curves. Then we tested whether a universal threshold can be used to delineate the epileptogenic zone across patients from different institutions. Relative entropy in the ripple band (80-250 Hz) achieved an average AUROC of .85. The normalized high-frequency oscillation rate in the ripple band showed an identical AUROC of .85. In contrast to high-frequency oscillations, relative entropy did not require any patient-level normalization and was easy and fast to calculate due to its clear and straightforward definition. One threshold could be set across different patients and institutions, because relative entropy is independent of signal amplitude and sampling frequency. Although both relative entropy and high-frequency oscillations have a similar performance, relative entropy has significant advantages such as straightforward definition, computational speed, and universal interpatient threshold, making it an easy-to-use promising biomarker of the epileptogenic zone.

High-frequency oscillations in the ripple bands and amplitude information coding: Toward a biomarker of maximum entropy in the preictal signals.

Intracranial electroencephalography (iEEG) can directly record local field potentials (LFPs) from a large set of neurons in the vicinity of the electrode. To search for possible epileptic biomarkers and to determine the epileptogenic zone that gives rise to seizures, we investigated the dynamics of basal and preictal signals. For this purpose, we explored the dynamics of the recorded time series for different frequency bands considering high-frequency oscillations (HFO) up to 240 Hz. We apply a Hilbert transform to study the amplitude and phase of the signals. The dynamics of the different frequency bands in the time causal entropy-complexity plane, H × C, is characterized by comparing the dynamical evolution of the basal and preictal time series. As the preictal states evolve closer to the time in which the epileptic seizure starts, the, H × C, dynamics changes for the higher frequency bands. The complexity evolves to very low values and the entropy becomes nearer to its maximal value. These quasi-stable states converge to equiprobable states when the entropy is maximal, and the complexity is zero. We could, therefore, speculate that in this case, it corresponds to the minimization of Gibbs free energy. In this case, the maximum entropy is equivalent to the principle of minimum consumption of resources in the system. We can interpret this as the nature of the system evolving temporally in the preictal state in such a way that the consumption of resources by the system is minimal for the amplitude in frequencies between 220-230 and 230-240 Hz.

0147 Electrophysiologic Localization of Pathological Brain Tissue Is Accomplished with Intracranial Sleep Staging

0147 Electrophysiologic Localization of Pathological Brain Tissue Is Accomplished with Intracranial Sleep Staging

Protocol for multicentre comparison of interictal high-frequency oscillations as a predictor of seizure freedom.

In drug-resistant focal epilepsy, interictal high-frequency oscillations (HFOs) recorded from intracranial EEG (iEEG) may provide clinical information for delineating epileptogenic brain tissue. The iEEG electrode contacts that contain HFO are hypothesized to delineate the epileptogenic zone; their resection should then lead to postsurgical seizure freedom. We test whether our prospective definition of clinically relevant HFO is in agreement with postsurgical seizure outcome. The algorithm is fully automated and is equally applied to all data sets. The aim is to assess the reliability of the proposed detector and analysis approach.We use an automated data-independent prospective definition of clinically relevant HFO that has been validated in data from two independent epilepsy centres. In this study, we combine retrospectively collected data sets from nine independent epilepsy centres. The analysis is blinded to clinical outcome. We use iEEG recordings during NREM sleep with a minimum of 12 epochs of 5 min of NREM sleep. We automatically detect HFO in the ripple (80–250 Hz) and in the fast ripple (250–500 Hz) band. There is no manual rejection of events in this fully automated algorithm. The type of HFO that we consider clinically relevant is defined as the simultaneous occurrence of a fast ripple and a ripple. We calculate the temporal consistency of each patient’s HFO rates over several data epochs within and between nights. Patients with temporal consistency <50% are excluded from further analysis. We determine whether all electrode contacts with high HFO rate are included in the resection volume and whether seizure freedom (ILAE 1) was achieved at ≥2 years follow-up. Applying a previously validated algorithm to a large cohort from several independent epilepsy centres may advance the clinical relevance and the generalizability of HFO analysis as essential next step for use of HFO in clinical practice.

Role of Pharmacological Modulation of Tonic Inhibition in Hippocampal Sharp Wave Ripples Amplitude and Place Cell Firing Dynamics

Hippocampal hyperactivity is a hallmark of memory dysfunction associated with age related mild cognitive impairment (aMCI) and Alzheimer’s disease, leading to the hypothesis that hippocampal trisynaptic circuit hyperactivity impairs memory function. As a test of this hypothesis, we sought to pharmacologically recapitulate hyperactivity in young adults by attenuating tonic inhibition in the hippocampal trisynaptic circuit. We used chronically implanted arrays of 96 electrodes arranged as tetrodes and 32 channel silicon probes to record place cell activity within and across the CA1 subregion of young adult rats either foraging in familiar and novel environments or resting in a familiar environment (without foraging) while awake but immobile for ripple band recordings. We demonstrate that oral administration of the nootropic drug α5IA, a selective negative modulator of tonically active predominantly extrasynaptic α5 GABA receptors, enhances CA1 place cell firing rates but does not augment spatial information content or pattern separation expected a priori to reflect nootropic drug action. This conundrum is resolved by the finding that α5IA substantially increases the sharp wave ripple (SPW‐R) amplitude, which is known to correlate with improved remembering. We replicated to result in three strains of rats (Long Evans, Fisher 344, and Sprague Dawley) and found that the outcomes were not strain specific. These observations indicate that the nootropic actions of α5IA may result from enhancement of aspects of memory function influenced by CA1 SPW‐R amplitude such as consolidation of encoded information. We posit that modulation of ripple dynamics may be controlled via alterations in extrasynaptic tonic inhibition mediated in part by α5 GABA‐A receptors.

Using magnetic resonance fingerprinting to characterize periventricular nodular heterotopias in pharmacoresistant epilepsy.

We aimed to use a novel magnetic resonance fingerprinting (MRF) technique to examine in vivo tissue property characteristics of periventricular nodular heterotopia (PVNH). These characteristics were further correlated with stereotactic-electroencephalographic (SEEG) ictal onset findings. We included five patients with PVNH who had SEEG-guided surgery and at least 1 year of seizure freedom or substantial seizure reduction. High-resolution MRF scans were acquired at 3 T, generating three-dimensional quantitative T1 and T2 maps. We assessed the differences between T1 and T2 values from the voxels in the nodules located in the SEEG-defined seizure onset zone (SOZ) and non-SOZ, on -individual and group levels. Receiver operating characteristic analyses were performed to obtain the optimal classification performance. Quantification of SEEG ictal onset signals from the nodules was performed by calculating power spectrum density (PSD). The association between PSD and T1 /T2 values was further assessed at different frequency bands. Individual-level analysis showed T1 was significantly higher in SOZ voxels than non-SOZ voxels (p<.05), with an average 73% classification accuracy. Group-level analysis also showed higher T1 was significantly associated with SOZ voxels (p<.001). At the optimal cutoff (normalized T1 of 1.1), a 76% accuracy for classifying SOZ nodules from non-SOZ nodules was achieved. T1 values were significantly associated with ictal onset PSD at the ultraslow, θ, β, γ, and ripple bands (p<.05). T2 values were significantly associated with PSD only at the ultraslow band (p<.05). Quantitative MRF measures, especially T1 , can provide additional noninvasive information to separate nodules in SOZ and non-SOZ. The T1 and T2 tissue property changes carry electrophysiological underpinnings relevant to the epilepsy, as shown by their significant positive associations with power changes during the SEEG seizure onset. The use of MRF as a supplementary noninvasive tool may improve presurgical evaluation for patients with PVNH and pharmacoresistant epilepsy.

A machine learning approach to characterize sequential movement-related states in premotor and motor cortices.

Nonhuman primate (NHP) movement kinematics have been decoded from spikes and local field potentials (LFPs) recorded during motor tasks. However, the potential of LFPs to provide network-like characterizations of neural dynamics during planning and execution of sequential movements requires further exploration. Is the aggregate nature of LFPs suitable to construct informative brain state descriptors of movement preparation and execution? To investigate this, we developed a framework to process LFPs based on machine-learning classifiers and analyzed LFP from a primate, implanted with several microelectrode arrays covering the premotor cortex in both hemispheres and the primary motor cortex on one side. The monkey performed a reach-to-grasp task, consisting of five consecutive states, starting from rest until a rewarding target (food) was attained. We use this five-state task to characterize neural activity within eight frequency bands, using spectral amplitude and pairwise correlations across electrodes as features. Our results show that we could best distinguish all five movement-related states using the highest frequency band (200-500 Hz), yielding an 87% accuracy with spectral amplitude, and 60% with pairwise electrode correlation. Further analyses characterized each movement-related state, showing differential neuronal population activity at above-γ frequencies during the various stages of movement. Furthermore, the topological distribution for the high-frequency LFPs allowed for a highly significant set of pairwise correlations, strongly suggesting a concerted distribution of movement planning and execution function is distributed across premotor and primary motor cortices in a specific fashion, and is most significant in the low ripple (100-150 Hz), high ripple (150-200 Hz), and multiunit frequency bands. In summary, our results show that the concerted use of novel machine-learning techniques with coarse grained queue broad signals such as LFPs may be successfully used to track and decode fine movement aspects involving preparation, reach, grasp, and reward retrieval across several brain regions.NEW & NOTEWORTHY Local field potentials (LFPs), despite lower spatial resolution compared to single-neuron recordings, can be used with machine learning classifiers to decode sequential movements involving motor preparation, execution, and reward retrieval. Our results revealed heterogeneity of neural activity on small spatial scales, further evidencing the utility of micro-electrode array recordings for complex movement decoding. With further advancement, high-dimensional LFPs may become the gold standard for brain-computer interfaces such as neural prostheses in the near future.

Effect of Training on Visual Identification of High Frequency Oscillations-A Delphi-Style Intervention.

ObjectiveWe examined the effect of a simple Delphi-method feedback on visual identification of high frequency oscillations (HFOs) in the ripple (80–250 Hz) band, and assessed the impact of this training intervention on the interrater reliability and generalizability of HFO evaluations.MethodsWe employed a morphology detector to identify potential HFOs at two thresholds and presented them to visual reviewers to assess the probability of each epoch containing an HFO. We recruited 19 board-certified epileptologists with various levels of experience to complete a series of HFO evaluations during three sessions. A Delphi-style intervention was used to provide feedback on the performance of each reviewer relative to their peers. A delayed-intervention paradigm was used, in which reviewers received feedback either before or after the second session. ANOVAs were used to assess the effect of the intervention on the reviewers' evaluations. Generalizability theory was used to assess the interrater reliability before and after the intervention.ResultsThe intervention, regardless of when it occurred, resulted in a significant reduction in the variability between reviewers in both groups (pGroupDI = 0.037, pGroupEI = 0.003). Prior to the delayed-intervention, the group receiving the early intervention showed a significant reduction in variability (pGroupEI = 0.041), but the delayed-intervention group did not (pGroupDI = 0.414). Following the intervention, the projected number of reviewers required to achieve strong generalizability decreased from 35 to 16.SignificanceThis study shows a robust effect of a Delphi-style intervention on the interrater variability, reliability, and generalizability of HFO evaluations. The observed decreases in HFO marking discrepancies across 14 of the 15 reviewers are encouraging: they are necessarily associated with an increase in interrater reliability, and therefore with a corresponding decrease in the number of reviewers required to achieve strong generalizability. Indeed, the reliability of all reviewers following the intervention was similar to that of experienced reviewers prior to intervention. Therefore, a Delphi-style intervention could be implemented either to sufficiently train any reviewer, or to further refine the interrater reliability of experienced reviewers. In either case, a Delphi-style intervention would help facilitate the standardization of HFO evaluations and its implementation in clinical care.

A neuromorphic spiking neural network detects epileptic high frequency oscillations in the scalp EEG

Interictal High Frequency Oscillations (HFO) are measurable in scalp EEG. This development has aroused interest in investigating their potential as biomarkers of epileptogenesis, seizure propensity, disease severity, and treatment response. The demand for therapy monitoring in epilepsy has kindled interest in compact wearable electronic devices for long-term EEG recording. Spiking neural networks (SNN) have emerged as optimal architectures for embedding in compact low-power signal processing hardware. We analyzed 20 scalp EEG recordings from 11 pediatric focal lesional epilepsy patients. We designed a custom SNN to detect events of interest (EoI) in the 80–250 Hz ripple band and reject artifacts in the 500–900 Hz band. We identified the optimal SNN parameters to detect EoI and reject artifacts automatically. The occurrence of HFO thus detected was associated with active epilepsy with 80% accuracy. The HFO rate mirrored the decrease in seizure frequency in 8 patients (p = 0.0047). Overall, the HFO rate correlated with seizure frequency (rho = 0.90 CI [0.75 0.96], p < 0.0001, Spearman’s correlation). The fully automated SNN detected clinically relevant HFO in the scalp EEG. This study is a further step towards non-invasive epilepsy monitoring with a low-power wearable device.

Ripples reflect a spectrum of synchronous spiking activity in human anterior temporal lobe.

Direct brain recordings have provided important insights into how high-frequency activity captured through intracranial EEG (iEEG) supports human memory retrieval. The extent to which such activity is comprised of transient fluctuations that reflect the dynamic coordination of underlying neurons, however, remains unclear. Here, we simultaneously record iEEG, local field potential (LFP), and single unit activity in the human temporal cortex. We demonstrate that fast oscillations within the previously identified 80-120 Hz ripple band contribute to broadband high-frequency activity in the human cortex. These ripple oscillations exhibit a spectrum of amplitudes and durations related to the amount of underlying neuronal spiking. Ripples in the macro-scale iEEG are related to the number and synchrony of ripples in the micro-scale LFP, which in turn are related to the synchrony of neuronal spiking. Our data suggest that neural activity in the human temporal lobe is organized into transient bouts of ripple oscillations that reflect underlying bursts of spiking activity.

Refining epileptogenic high-frequency oscillations using deep learning: a reverse engineering approach.

Intracranially recorded interictal high-frequency oscillations have been proposed as a promising spatial biomarker of the epileptogenic zone. However, its visual verification is time-consuming and exhibits poor inter-rater reliability. Furthermore, no method is currently available to distinguish high-frequency oscillations generated from the epileptogenic zone (epileptogenic high-frequency oscillations) from those generated from other areas (non-epileptogenic high-frequency oscillations). To address these issues, we constructed a deep learning-based algorithm using chronic intracranial EEG data via subdural grids from 19 children with medication-resistant neocortical epilepsy to: (i) replicate human expert annotation of artefacts and high-frequency oscillations with or without spikes, and (ii) discover epileptogenic high-frequency oscillations by designing a novel weakly supervised model. The ‘purification power’ of deep learning is then used to automatically relabel the high-frequency oscillations to distill epileptogenic high-frequency oscillations. Using 12 958 annotated high-frequency oscillation events from 19 patients, the model achieved 96.3% accuracy on artefact detection (F1 score = 96.8%) and 86.5% accuracy on classifying high-frequency oscillations with or without spikes (F1 score = 80.8%) using patient-wise cross-validation. Based on the algorithm trained from 84 602 high-frequency oscillation events from nine patients who achieved seizure-freedom after resection, the majority of such discovered epileptogenic high-frequency oscillations were found to be ones with spikes (78.6%, P < 0.001). While the resection ratio of detected high-frequency oscillations (number of resected events/number of detected events) did not correlate significantly with post-operative seizure freedom (the area under the curve = 0.76, P = 0.06), the resection ratio of epileptogenic high-frequency oscillations positively correlated with post-operative seizure freedom (the area under the curve = 0.87, P = 0.01). We discovered that epileptogenic high-frequency oscillations had a higher signal intensity associated with ripple (80–250 Hz) and fast ripple (250–500 Hz) bands at the high-frequency oscillation onset and with a lower frequency band throughout the event time window (the inverted T-shaped), compared to non-epileptogenic high-frequency oscillations. We then designed perturbations on the input of the trained model for non-epileptogenic high-frequency oscillations to determine the model’s decision-making logic. The model confidence significantly increased towards epileptogenic high-frequency oscillations by the artificial introduction of the inverted T-shaped signal template (mean probability increase: 0.285, P < 0.001), and by the artificial insertion of spike-like signals into the time domain (mean probability increase: 0.452, P < 0.001). With this deep learning-based framework, we reliably replicated high-frequency oscillation classification tasks by human experts. Using a reverse engineering technique, we distinguished epileptogenic high-frequency oscillations from others and identified its salient features that aligned with current knowledge.

Ripple band phase precession of place cell firing during replay

SummaryNeuronal “replay,” in which place cell firing during rest recapitulates recently experienced trajectories, is thought to mediate the transmission of information from hippocampus to neocortex, but the mechanism for this transmission is unknown. Here, we show that replay uses a phase code to represent spatial trajectories by the phase of firing relative to the 150- to 250-Hz “ripple” oscillations that accompany replay events. This phase code is analogous to the theta phase precession of place cell firing during navigation, in which place cells fire at progressively earlier phases of the 6- to 12-Hz theta oscillation as their place field is traversed, providing information about self-location that is additional to the rate code and a necessary precursor of replay. Thus, during replay, each ripple cycle contains a “forward sweep” of decoded locations along the recapitulated trajectory. Our results indicate a novel encoding of trajectory information during replay and implicates phase coding as a general mechanism by which the hippocampus transmits experienced and replayed sequential information to downstream targets.