論文

国際誌
2021年4月1日

Effects of a stable concentration of propofol on interictal high-frequency oscillations in drug-resistant epilepsy.

Epileptic disorders : international epilepsy journal with videotape
  • Taku Inada
  • Katsuya Kobayashi
  • Takayuki Kikuchi
  • Masao Matsuhashi
  • Riki Matsumoto
  • Yuki Takahashi
  • Takuro Nakae
  • Sumiya Shibata
  • Yukihiro Yamao
  • Masako Daifu
  • Jumpei Togawa
  • Kazumichi Yoshida
  • Takeharu Kunieda
  • Katsuhiro Kobayashi
  • Akio Ikeda
  • Susumu Miyamoto
  • 全て表示

23
2
開始ページ
299
終了ページ
312
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1684/epd.2021.1264

The aim of this study was to clarify the effect of a stable concentration of propofol on interictal high-frequency oscillations (HFOs), which may contribute to identifying the epileptogenic zone intraoperatively for resection surgery. Nine patients with drug-resistant focal epilepsy who underwent invasive pre-surgical evaluation with chronic subdural electrodes were recruited. Five-minute electrocorticograms during wakefulness, slow-wave sleep, and under a stable brain concentration of propofol were recorded with the same electrodes. In each patient, 1-10 pairs of electrodes were selected for both electrodes with EEG changes within 5 seconds from the ictal onset (ictal pattern for 5 seconds [IP5]) and those outside the area of IP5 with no interictal epileptiform discharges (non-epileptiform [nEPI]). The numbers of ripples (80-250 Hz) and fast ripples (>250 Hz) were measured semi-automatically using an established algorithm. Statistical testing was performed with a mixed effect model. Thirty-seven pairs of electrodes from nine patients were analysed for IP5 and 29 pairs from seven patients were analysed for nEPI. The numbers of HFOs differed between the areas (IP5 and nEPI) and among the conditions (wakefulness, slow-wave sleep, propofol anaesthesia) (all p <0.01). The HFO occurrence rates were significantly higher for IP5 than those for nEPI in all conditions (for both ripples and fast ripples in all conditions; p <0.01). The occurrence rates of HFOs for IP5 were significantly higher than those for nEPI under propofol anaesthesia. These are fundamental findings for intraoperative HFO analysis, however, the following limitations should be considered: physiological HFOs could not be completely differentiated from pathological HFOs; in order to apply an HFO detector, an appropriate cut-off threshold is needed; an artefact of the impulse response filter appears as an HFO; and the series was comprised of a small number of heterogeneous patients.

リンク情報
DOI
https://doi.org/10.1684/epd.2021.1264
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/33855965
ID情報
  • DOI : 10.1684/epd.2021.1264
  • PubMed ID : 33855965

エクスポート
BibTeX RIS