现代脑电图(EEG)技术的进步增强了对经典伯杰频段外,包含重要信息的脑电信号的识别。在癫痫领域,近十年的相关研究主要集中在发作间期>80 Hz 的高频振荡(High frequency oscillations, HFOs)。HFOs 大型临床应用始于癫痫手术术前的评估,近来也开始用于评估癫痫严重程度和监测抗癫痫疗效。该综述总结了 HFOs 在癫痫临床应用的证据,重点介绍了最新的进展。近期大量文献强调了 HFOs 与术后癫痫预后关系,一篇近期的 Meta 分析证实术后癫痫未发作患者 HFOs 切除率高于术后发作患者,利用术后 EEG 中的残留 HFOs 比术前 HFOs 率对癫痫手术预后预测更准确。文章深入讨论了区分生理性和癫痫性 HFOs 的尝试,这可能进一步加强 HFOs 的特异度。如睡眠结构分析表明,在痫灶内外对 HFOs 的偶联有差异。同时,越来越多的证据表明,HFOs 可用于对评估疾病活动度和利用非侵入性 EEG 和脑磁图(MEG)等检查中评估治疗效果。鉴于儿童 EEG 中 HFOs 比例高,这一技术在患儿中有良好的前景。在婴儿痉挛症中经促肾上腺皮质激素治疗后 HFOs 比例下降。在Rolandic区棘波时出现 HFOs 与发作频率相关。耗时的人工评估是过去 HFOs 临床应用的障碍,目前这一问题可由可靠的计算机算法解决。过去十年,HFOs 研究有了长足进展,利用非侵入性手段检测 HFOs 已在大量患者中得到应用。期待未来有多中心、大样本量研究获取长程监测资料,为这一领域提供更多信息。
Citation: BirgitFrauscher, FabriceBartolomei, KatsuhiroKobayashi, 陆璐 译, 张乐 慕洁 审. 高频脑电振荡:临床研究综述. Journal of Epilepsy, 2018, 4(6): 545-557. doi: 10.7507/2096-0247.20180086 Copy
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- 1. Jacobs J, Staba R, Asano E, et al. High-frequency oscillations (HFOs) in clinical epilepsy. Prog Neurobiol, 2012, 98(3): 302-315.
- 2. Bragin A, Engel J Jr, Wilson CL, et al. High-frequency oscillations in human brain. Hippocampus, 1999, 9: 137-142.
- 3. Zijlmans M, Worrell GA, Dümpelmann M. How to record high-frequency oscillations in epilepsy: a practical guideline. Epilepsia, 2017, 58(8): 1305-1315.
- 4. Allen PJ, Fish DR, Smith SJ. Very high-frequency rhythmic activity during SEEG suppression in frontal lobe epilepsy. Electroencephalogr Clin Neurophysiol, 1992, 82(2): 155-159.
- 5. Fisher RS, Webber WR, Lesser RP, et al. High-frequency EEG activity at the start of seizures. J Clin Neurophysiol, 1992, 9(3): 441-448.
- 6. Bragin A, Engel J Jr, Wilson CL, et al. Hippocampal and entorhinal cortex high-frequency oscillations (100-500 Hz) in human epileptic brain and in kainic acid-treated rats with chronic seizures. Epilepsia, 1999, 40(2): 127-137.
- 7. Bragin A, Engel J Jr, Wilson CL, et al. Electrophysiologic analysis of a chronic seizure model after unilateral hippocampal KA injection. Epilepsia, 1999, 40(9): 1210-1221.
- 8. Bragin A, Wilson CL, Staba RJ, et al. Interictal high-frequency oscillations (80-500 Hz) in the human epileptic brain: entorhinal cortex. Ann Neurol, 2002, 52(4): 407-415.
- 9. Staba RJ, Wilson CL, Bragin A, et al. High-frequency oscillations recorded in human medial temporal lobe during sleep. Ann Neurol, 2004, 56(1): 108-115.
- 10. Jirsch JD, Urrestarazu E, LeVan P, et al. High-frequency oscillations during human focal seizures. Brain, 2006, 129(Pt 6): 1593-1608.
- 11. Urrestarazu E, Jirsch JD, LeVan P, et al. High-frequency intracerebral EEG activity (100-500 Hz) following interictal spikes. Epilepsia, 2006, 47(9): 1465-1476.
- 12. Akiyama T, Otsubo H, Ochi A, et al. Focal cortical high-frequency oscillations trigger epileptic spasms: confirmation by digital video sub-dural EEG. Clin Neurophysiol, 2005, 116: 2819-2825.
- 13. Chátillon CÉ, Zelmann R, Bortel A, et al. Contact size does not affect high frequency oscillation detection in intracerebral EEG recordings in a rat epilepsy model. Clin Neurophysiol, 2011, 122(9): 1701-1705.
- 14. Kobayashi K, Watanabe Y, Inoue T, et al. Scalp-recorded high-frequency oscillations in childhood sleep-induced electrical status epilepticus. Epilepsia, 2010, 51(10): 2190-2194.
- 15. Andrade-Valenca LP, Dubeau F, Mari F, et al. Interictal scalp fast oscillations as a marker of the seizure onset zone. Neurology, 2011, 77(6): 524-531.
- 16. Xiang J, Liu Y, Wang Y, et al. Frequency and spatial characteristics of high-frequency neuromagnetic signals in childhood epilepsy. Epileptic Disord, 2009, 11(2): 113-125.
- 17. van Klink N, Hillebrand A, Zijlmans M. Identification of epileptic high frequency oscillations in the time domain by using MEG beamformer-based virtual sensors. Clin Neurophysiol, 2016, 127(1): 197-208.
- 18. von Ellenrieder N, Pellegrino G, Hedrich T, et al. Detection and magnetic source imaging of fast oscillations (40-160 Hz) recorded with magnetoencephalography in focal epilepsy patients. Brain Topogr, 2016, 29(2): 218-231.
- 19. Urrestarazu E, Chander R, Dubeau F, et al. Interictal high-frequency oscillations (100-500 Hz) in the intracerebral EEG of epileptic patients. Brain, 2007, 130(Pt 9): 2354-2366.
- 20. Jiruska, P, Alvarado-Rojas C, Schevon, C A, et al. Update on the mechanisms and roles of high-frequency oscillations in seizures and epileptic disorders. Epilepsia, 2017, 58(8): 1330-1339.
- 21. Khosravani H, Mehrotra N, Rigby M, et al. Spatial localization and time-dependant changes of electrographic high frequency oscillations in human temporal lobe epilepsy. Epilepsia, 2009, 50(4): 605-616.
- 22. Zijlmans M, Jacobs J, Zelmann R, et al. High-frequency oscillations mirror disease activity in patients with epilepsy. Neurology, 2009, 72: 979-986.
- 23. Gotman J, Marciani MG. Electroencephalographic spiking activity, drug levels, and seizure occurrence in epileptic patients. Ann Neurol, 1985, 17(6): 597-603.
- 24. Goncharova II, Alkawadri R, Gaspard N, et al. The relationship between seizures, interictal spikes and antiepileptic drugs. Clin Neurophysiol, 2016, 127(9): 3180-3186.
- 25. Jacobs J, LeVan P, Chander R, et al. Interictal high-frequency oscillations (80-500 Hz) are an indicator of seizure onset areas independent of spikes in the human epileptic brain. Epilepsia, 2008, 49(11): 1893-1907.
- 26. Wang S, Wang IZ, Bulacio JC, et al. Ripple classification helps to localize the seizure-onset zone in neocortical epilepsy. Epilepsia, 2013, 54(2): 370-376.
- 27. Bénar CG, Chauvière L, Bartolomei F, et al. Pitfalls of high-pass filtering for detecting epileptic oscillations: a technical note on" false”ripples. Clin Neurophysiol, 2010, 121(3): 301-310.
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