Sawtooth waves (STW) are bursts of frontocentral slow oscillations recorded in the scalp electroencephalogram (EEG) during rapid eye movement (REM) sleep. Little is known about their cortical generators and functional significance. Stereo-EEG performed for presurgical epilepsy evaluation offers the unique possibility to study neurophysiology in situ in the human brain. We investigated intracranial correlates of scalp-detected STW in 26 patients (14 women) undergoing combined stereo-EEG/polysomnography. We visually marked STW segments in scalp EEG and selected stereo-EEG channels exhibiting normal activity for intracranial analyses. Channels were grouped in 30 brain regions. The spectral power in each channel and frequency band was computed during STW and non-STW control segments. Ripples (80-250 Hz) were automatically detected during STW and control segments. The spectral power in the different frequency bands and the ripple rates were then compared between STW and control segments in each brain region. An increase in 2-4 Hz power during STW segments was found in all brain regions, except the occipital lobe, with large effect sizes in the parietotemporal junction, the lateral and orbital frontal cortex, the anterior insula, and mesiotemporal structures. A widespread increase in high-frequency activity, including ripples, was observed concomitantly, involving the sensorimotor cortex, associative areas, and limbic structures. This distribution showed a high spatiotemporal heterogeneity. Our results suggest that STW are associated with widely distributed, but locally regulated REM sleep slow oscillations. By driving fast activities, STW may orchestrate synchronized reactivations of multifocal activities, allowing tagging of complex representations necessary for REM sleep-dependent memory consolidation.SIGNIFICANCE STATEMENT Sawtooth waves (STW) present as scalp electroencephalographic (EEG) bursts of slow waves contrasting with the low-voltage fast desynchronized activity of REM sleep. Little is known about their cortical origin and function. Using combined stereo-EEG/polysomnography possible only in the human brain during presurgical epilepsy evaluation, we explored the intracranial correlates of STW. We found that a large set of regions in the parietal, frontal, and insular cortices shows increases in 2-4 Hz power during scalp EEG STW, that STW are associated with a strong and widespread increase in high frequencies, and that these slow and fast activities exhibit a high spatiotemporal heterogeneity. These electrophysiological properties suggest that STW may be involved in cognitive processes during REM sleep.

• MeSH
• dospělí MeSH
• elektrokortikografie * MeSH
• lidé středního věku MeSH
• lidé MeSH
• mapování mozku MeSH
• mladý dospělý MeSH
• mozková kůra fyziologie   MeSH
• polysomnografie MeSH
• spánek REM fyziologie   MeSH
• stadia spánku fyziologie   MeSH
• vlnková analýza MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

High-frequency oscillations (HFOs) represent an electrographic biomarker of endogenous epileptogenicity and seizure-generating tissue that proved clinically useful in presurgical planning and delineating the resection area. In the neocortex, the clinical observations on HFOs are not sufficiently supported by experimental studies stemming from a lack of realistic neocortical epilepsy models that could provide an explanation of the pathophysiological substrates of neocortical HFOs. In this study, we explored pathological epileptiform network phenomena, particularly HFOs, in a highly realistic murine model of neocortical epilepsy due to focal cortical dysplasia (FCD) type II. FCD was induced in mice by the expression of the human pathogenic mTOR gene mutation during embryonic stages of brain development. Electrographic recordings from multiple cortical regions in freely moving animals with FCD and epilepsy demonstrated that the FCD lesion generates HFOs from all frequency ranges, i.e., gamma, ripples, and fast ripples up to 800 Hz. Gamma-ripples were recorded almost exclusively in FCD animals, while fast ripples occurred in controls as well, although at a lower rate. Gamma-ripple activity is particularly valuable for localizing the FCD lesion, surpassing the utility of fast ripples that were also observed in control animals, although at significantly lower rates. Propagating HFOs occurred outside the FCD, and the contralateral cortex also generated HFOs independently of the FCD, pointing to a wider FCD network dysfunction. Optogenetic activation of neurons carrying mTOR mutation and expressing Channelrhodopsin-2 evoked fast ripple oscillations that displayed spectral and morphological profiles analogous to spontaneous oscillations. This study brings experimental evidence that FCD type II generates pathological HFOs across all frequency bands and provides information about the spatiotemporal properties of each HFO subtype in FCD. The study shows that mutated neurons represent a functionally interconnected and active component of the FCD network, as they can induce interictal epileptiform phenomena and HFOs.

• MeSH
• elektroencefalografie MeSH
• epilepsie * MeSH
• fokální kortikální dysplazie * MeSH
• lidé MeSH
• modely nemocí na zvířatech MeSH
• myši MeSH
• TOR serin-threoninkinasy MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• myši MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH

Interictal high-frequency oscillations (HFO) were recently identified in recordings from depth macroelectrodes in epileptic patients. StereoEEG (SEEG) recordings were analyzed in four patients with medically intractable partial seizures due to focal cortical dysplasia type IIA. Characteristics of HFO within seizure onset zone (SOZ), irritative zone, and remote brain areas were investigated. Whilst the rate of occurrence for ripples (80-200 Hz) was significantly higher in recordings from within than outside the SOZ, the rate of fast ripples (200-450 Hz) was less reliable index of SOZ. Interestingly, the mean powers across subjects were significantly higher within than outside the SOZ in both ripple and fast ripple frequency ranges. Our study demonstrates a capacity of interictal HFO to detect the SOZ in focal cortical dysplasias.

• MeSH
• analýza rozptylu MeSH
• dospělí MeSH
• elektrody MeSH
• elektroencefalografie metody   MeSH
• lidé středního věku MeSH
• lidé MeSH
• magnetická rezonanční tomografie metody   MeSH
• malformace mozkové kůry komplikace   patologie   MeSH
• mapování mozku MeSH
• mladiství MeSH
• mozek patofyziologie   MeSH
• počítačové zpracování signálu MeSH
• spektrální analýza MeSH
• záchvaty etiologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

OBJECTIVE: In the present study, we aimed to investigate depth electroencephalographic (EEG) recordings in a large cohort of patients with drug-resistant epilepsy and to focus on interictal very high-frequency oscillations (VHFOs) between 500Hz and 2kHz. We hypothesized that interictal VHFOs are more specific biomarkers for epileptogenic zone compared to traditional HFOs. METHODS: Forty patients with focal epilepsy who underwent presurgical stereo-EEG (SEEG) were included in the study. SEEG data were recorded with a sampling rate of 25kHz, and a 30-minute resting period was analyzed for each patient. Ten patients met selected criteria for analyses of correlations with surgical outcome: detection of interictal ripples (Rs), fast ripples (FRs), and VHFOs; resective surgery; and at least 1 year of postoperative follow-up. Using power envelope computation and visual inspection of power distribution matrixes, electrode contacts with HFOs and VHFOs were detected and analyzed. RESULTS: Interictal very fast ripples (VFRs; 500-1,000Hz) were detected in 23 of 40 patients and ultrafast ripples (UFRs; 1,000-2,000Hz) in almost half of investigated subjects (n = 19). VFRs and UFRs were observed only in patients with temporal lobe epilepsy and were recorded exclusively from mesiotemporal structures. The UFRs were more spatially restricted in the brain than lower-frequency HFOs. When compared to R oscillations, significantly better outcomes were observed in patients with a higher percentage of removed contacts containing FRs, VFRs, and UFRs. INTERPRETATION: Interictal VHFOs are relatively frequent abnormal phenomena in patients with epilepsy, and appear to be more specific biomarkers for epileptogenic zone when compared to traditional HFOs. Ann Neurol 2017;82:299-310.

• MeSH
• dospělí MeSH
• elektroencefalografie metody   MeSH
• endofenotypy * MeSH
• epilepsie parciální patofyziologie   chirurgie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mozkové vlny fyziologie   MeSH
• refrakterní epilepsie patofyziologie   chirurgie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Hippocampal high-frequency electrographic activity (HFOs) represents one of the major discoveries not only in epilepsy research but also in cognitive science over the past few decades. A fundamental challenge, however, has been the fact that physiological HFOs associated with normal brain function overlap in frequency with pathological HFOs. We investigated the impact of a cognitive task on HFOs with the aim of improving differentiation between epileptic and non-epileptic hippocampi in humans. Hippocampal activity was recorded with depth electrodes in 15 patients with focal epilepsy during a resting period and subsequently during a cognitive task. HFOs in ripple and fast ripple frequency ranges were evaluated in both conditions, and their rate, spectral entropy, relative amplitude and duration were compared in epileptic and non-epileptic hippocampi. The similarity of HFOs properties recorded at rest in epileptic and non-epileptic hippocampi suggests that they cannot be used alone to distinguish between hippocampi. However, both ripples and fast ripples were observed with higher rates, higher relative amplitudes and longer durations at rest as well as during a cognitive task in epileptic compared with non-epileptic hippocampi. Moreover, during a cognitive task, significant reductions of HFOs rates were found in epileptic hippocampi. These reductions were not observed in non-epileptic hippocampi. Our results indicate that although both hippocampi generate HFOs with similar features that probably reflect non-pathological phenomena, it is possible to differentiate between epileptic and non-epileptic hippocampi using a simple odd-ball task.

• MeSH
• dospělí MeSH
• elektroencefalografie přístrojové vybavení   MeSH
• epilepsie temporálního laloku diagnóza   patofyziologie   terapie   MeSH
• hipokampus patofyziologie   MeSH
• implantované elektrody MeSH
• kognice fyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mozkové vlny fyziologie   MeSH
• neuropsychologické testy MeSH
• refrakterní epilepsie diagnóza   patofyziologie   terapie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH
• práce podpořená grantem MeSH

OBJECTIVE: The main aim of this study was to investigate the potential differences in terms of interictal high frequency oscillations (HFOs) between both hippocampi in unilateral (U-MTLE) and bilateral mesial temporal lobe epilepsy (B-MTLE). METHODS: Sixteen patients with MTLE underwent bilateral hippocampal depth electrode implantation as part of epilepsy surgery evaluation. Interictal HFOs were detected automatically. The analyses entail comparisons of the rates and spatial distributions of ripples and fast ripples (FR) in hippocampi and amygdalae, with respect to the eventual finding of hippocampal sclerosis (HS). RESULTS: In U-MTLE, higher ripple and FR rates were found in the hippocampi ipsilateral to the seizure onset than in the contralateral hippocampi. Non-epileptic hippocampi in U-MTLE were distinguished by significantly lower ripple rate than in the remaining analyzed hippocampi. There were not differences between the hippocampi in B-MTLE. In the hippocampi with proven HS, higher FR rates were observed in the ventral than in the dorsal parts. CONCLUSIONS: Non-epileptic hippocampi in U-MTLE demonstrated significantly lower ripple rates than those epileptic in U-MTLE and B-MTLE. SIGNIFICANCE: Low interictal HFO occurrence might be considered as a marker of the non-epileptic hippocampi in MTLE.

• MeSH
• amygdala patofyziologie   MeSH
• dospělí MeSH
• elektroencefalografie metody   MeSH
• epilepsie temporálního laloku patologie   patofyziologie   MeSH
• hipokampus patologie   patofyziologie   MeSH
• implantované elektrody MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• retrospektivní studie MeSH
• spánkový lalok patofyziologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

OBJECTIVE: We compared the possible contribution (in the detection of seizure onset zone - SOZ) of simple visual assessment of intracerebrally recorded high-frequency oscillations (HFO) with standard automated detection. METHODS: We analyzed stereo-EEG (SEEG) recordings from 20 patients with medically intractable partial seizures (10 temporal/10 extratemporal). Independently using simple visual assessment and automated detection of HFO, we identified the depth electrode contacts with maximum occurrences of ripples (R) and fast ripples (FR). The SOZ was determined by independent visual identification in standard SEEG recordings, and the congruence of results from visual versus automated HFO detection was compared. RESULTS: Automated detection of HFO correctly identified the SOZ in 14 (R)/10 (FR) out of 20 subjects; a simple visual assessment of SEEG recordings in the appropriate frequency ranges correctly identified the SOZ in 13 (R)/9 (FR) subjects. CONCLUSIONS: Simple visual assessment of SEEG traces and standard automated detection of HFO seem to contribute comparably to the identification of the SOZ in patients with focal epilepsies. When using macroelectrodes in neocortical extratemporal epilepsies, the SOZ might be better determined by the ripple range. SIGNIFICANCE: Standard automated detection of HFO enables the evaluation of HFO characteristics in whole data. This detection allows general purpose and objective evaluation, without any bias from the neurophysiologist's experiences and practice.

• MeSH
• dospělí MeSH
• elektrody MeSH
• elektroencefalografie přístrojové vybavení   metody   MeSH
• epilepsie parciální diagnóza   MeSH
• hipokampus MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mozková kůra MeSH
• počítačové zpracování signálu MeSH
• reprodukovatelnost výsledků MeSH
• záchvaty diagnóza   MeSH
• zobrazování dat * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• hodnotící studie MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH

Highlights Simultaneous epileptiform LFPs and single-cell activity can be recorded in the membrane chamber.Interneuron firing can be linked to epileptiform high frequency activity.Fast ripples, unique to chronic epilepsy, can be modeled in ex vivo tissue from TeNT-treated rats. Traditionally, visually-guided patch clamp in brain slices using submerged recording conditions has been required to characterize the activity of individual neurons. However, due to limited oxygen availability, submerged conditions truncate fast network oscillations including epileptiform activity. Thus, it is technically challenging to study the contribution of individual identified neurons to fast network activity. The membrane chamber is a submerged-style recording chamber, modified to enhance oxygen supply to the slice, which we use to demonstrate the ability to record single-cell activity during in vitro epilepsy. We elicited epileptiform activity using 9 mM potassium and simultaneously recorded from fluorescently labeled interneurons. Epileptiform discharges were more reliable than in standard submerged conditions. During these synchronous discharges interneuron firing frequency increased and action potential amplitude progressively decreased. The firing of 15 interneurons was significantly correlated with epileptiform high frequency activity (HFA; ~100-500 Hz) cycles. We also recorded epileptiform activity in tissue prepared from chronically epileptic rats, treated with intrahippocampal tetanus neurotoxin. Four of these slices generated fast ripple activity, unique to chronic epilepsy. We showed the membrane chamber is a promising new in vitro environment facilitating patch clamp recordings in acute epilepsy models. Further, we showed that chronic epilepsy can be better modeled using ex vivo brain slices. These findings demonstrate that the membrane chamber facilitates previously challenging investigations into the neuronal correlates of epileptiform activity in vitro.

• MeSH
• elektrokortikografie MeSH
• epilepsie * diagnostické zobrazování   MeSH
• interneurony MeSH
• krysa rodu rattus MeSH
• metoda terčíkového zámku * metody   MeSH
• modely nemocí na zvířatech MeSH
• mozková kůra diagnostické zobrazování   MeSH
• techniky in vitro metody   MeSH
• zvířata MeSH
• Check Tag
• krysa rodu rattus MeSH
• zvířata MeSH
• Publikační typ
• práce podpořená grantem MeSH

OBJECTIVE: The purpose of the presented study is to determine whether there are frequency-independent high-frequency oscillation (HFO) parameters which may differ in epileptic and non-epileptic regions. METHODS: We studied 31 consecutive patients with medically intractable focal (temporal and extratemporal) epilepsies who were examined by either intracerebral or subdural electrodes. Automated detection was used to detect HFO. The characteristics (rate, amplitude, and duration) of HFO were statistically compared within three groups: the seizure onset zone (SOZ), the irritative zone (IZ), and areas outside the IZ and SOZ (nonSOZ/nonIZ). RESULTS: In all patients, fast ripples (FR) and ripples (R) were significantly more frequent and shorter in the SOZ than in the nonSOZ/nonIZ region. In the group of patients with favorable surgical outcomes, the relative amplitude of FR was higher in the SOZ than in the IZ and nonIZ/nonSOZ regions; in patients with poor outcomes, the results were reversed. The relative amplitude of R was significantly higher in the SOZ, with no difference between patients with poor and favorable surgical outcomes. CONCLUSIONS: FR are more frequent, shorter, and have higher relative amplitudes in the SOZ area than in other regions. The study suggests a worse prognosis in patients with higher amplitudes of FR outside the SOZ. SIGNIFICANCE: Various HFO parameters, especially of FR, differ in epileptic and non-epileptic regions. The amplitude and duration may be as important as the frequency band and rate of HFO in marking the seizure onset region or the epileptogenic area and may provide additional information on epileptogenicity.

• MeSH
• dospělí MeSH
• elektroencefalografie metody   MeSH
• epilepsie diagnóza   patofyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mapování mozku metody   MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mozek patofyziologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH

High frequency oscillations are associated with normal brain function, but also increasingly recognized as potential biomarkers of the epileptogenic brain. Their role in human cognition has been predominantly studied in classical gamma frequencies (30-100 Hz), which reflect neuronal network coordination involved in attention, learning and memory. Invasive brain recordings in animals and humans demonstrate that physiological oscillations extend beyond the gamma frequency range, but their function in human cognitive processing has not been fully elucidated. Here we investigate high frequency oscillations spanning the high gamma (50-125 Hz), ripple (125-250 Hz) and fast ripple (250-500 Hz) frequency bands using intracranial recordings from 12 patients (five males and seven females, age 21-63 years) during memory encoding and recall of a series of affectively charged images. Presentation of the images induced high frequency oscillations in all three studied bands within the primary visual, limbic and higher order cortical regions in a sequence consistent with the visual processing stream. These induced oscillations were detected on individual electrodes localized in the amygdala, hippocampus and specific neocortical areas, revealing discrete oscillations of characteristic frequency, duration and latency from image presentation. Memory encoding and recall significantly modulated the number of induced high gamma, ripple and fast ripple detections in the studied structures, which was greater in the primary sensory areas during the encoding (Wilcoxon rank sum test, P = 0.002) and in the higher-order cortical association areas during the recall (Wilcoxon rank sum test, P = 0.001) of memorized images. Furthermore, the induced high gamma, ripple and fast ripple responses discriminated the encoded and the affectively charged images. In summary, our results show that high frequency oscillations, spanning a wide range of frequencies, are associated with memory processing and generated along distributed cortical and limbic brain regions. These findings support an important role for fast network synchronization in human cognition and extend our understanding of normal physiological brain activity during memory processing.

• MeSH
• afekt fyziologie   MeSH
• amygdala fyziologie   chirurgie   MeSH
• dospělí MeSH
• elektroencefalografie přístrojové vybavení   metody   MeSH
• funkční zobrazování neurálních procesů MeSH
• hipokampus fyziologie   chirurgie   MeSH
• implantované elektrody MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mozková kůra fyziologie   MeSH
• mozkové vlny fyziologie   MeSH
• nervová síť fyziologie   MeSH
• paměť fyziologie   MeSH
• rozpomínání fyziologie   MeSH
• rozpoznávání (psychologie) fyziologie   MeSH
• somatosenzorické korové centrum fyziologie   MeSH
• velký mozek fyziologie   MeSH
• zraková percepce fyziologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Research Support, N.I.H., Extramural MeSH