TY - JOUR
T1 - Accurate differentiation between physiological and pathological ripples recorded with scalp-EEG
AU - Mooij, Anne H.
AU - Huiskamp, Geertjan J.M.
AU - Aarts, Emmeke
AU - Ferrier, Cyrille H.
AU - Braun, Kees P.J.
AU - Zijlmans, Maeike
N1 - Funding Information:
This work was supported by the Dutch Epilepsy Foundation (grant number 15-09) and by the Netherlands Organization for Health Research and Development (Veni grant 91615149).
Publisher Copyright:
© 2022 International Federation of Clinical Neurophysiology
PY - 2022/11
Y1 - 2022/11
N2 - Objective: To compare scalp-EEG recorded physiological ripples co-occurring with vertex waves to pathological ripples co-occurring with interictal epileptiform discharges (IEDs). Methods: We marked ripples in sleep EEGs of children. We compared the start of ripples to vertex wave- or IED-start, and duration, frequency, and root mean square (RMS) amplitude of physiological and pathological ripples using multilevel modeling. Ripples were classified as physiological or pathological using linear discriminant analysis. Results: We included 40 children with and without epilepsy. Ripples started (χ
2(1) = 38.59, p < 0.001) later if they co-occurred with vertex waves (108.2 ms after vertex wave-start) than if they co-occurred with IEDs (4.3 ms after IED-start). Physiological ripples had longer durations (75.7 ms vs 53.0 ms), lower frequencies (98.3 Hz vs 130.6 Hz), and lower RMS amplitudes (0.9 μV vs 1.8 μV, all p < 0.001) than pathological ripples. Ripples could be classified as physiological or pathological with 98 % accuracy. Ripples recorded in children with idiopathic or symptomatic epilepsy seemed to form two subgroups of pathological ripples. Conclusions: Ripples co-occurring with vertex waves or IEDs have different characteristics and can be differentiated as physiological or pathological with high accuracy. Significance: This is the first study that compares physiological and pathological ripples recorded with scalp EEG.
AB - Objective: To compare scalp-EEG recorded physiological ripples co-occurring with vertex waves to pathological ripples co-occurring with interictal epileptiform discharges (IEDs). Methods: We marked ripples in sleep EEGs of children. We compared the start of ripples to vertex wave- or IED-start, and duration, frequency, and root mean square (RMS) amplitude of physiological and pathological ripples using multilevel modeling. Ripples were classified as physiological or pathological using linear discriminant analysis. Results: We included 40 children with and without epilepsy. Ripples started (χ
2(1) = 38.59, p < 0.001) later if they co-occurred with vertex waves (108.2 ms after vertex wave-start) than if they co-occurred with IEDs (4.3 ms after IED-start). Physiological ripples had longer durations (75.7 ms vs 53.0 ms), lower frequencies (98.3 Hz vs 130.6 Hz), and lower RMS amplitudes (0.9 μV vs 1.8 μV, all p < 0.001) than pathological ripples. Ripples could be classified as physiological or pathological with 98 % accuracy. Ripples recorded in children with idiopathic or symptomatic epilepsy seemed to form two subgroups of pathological ripples. Conclusions: Ripples co-occurring with vertex waves or IEDs have different characteristics and can be differentiated as physiological or pathological with high accuracy. Significance: This is the first study that compares physiological and pathological ripples recorded with scalp EEG.
KW - HFOs
KW - High-frequency oscillations
KW - Interictal epileptiform discharge
KW - Surface EEG
KW - Vertex sharp transients
UR - http://www.scopus.com/inward/record.url?scp=85138061030&partnerID=8YFLogxK
U2 - 10.1016/j.clinph.2022.08.014
DO - 10.1016/j.clinph.2022.08.014
M3 - Article
C2 - 36115810
SN - 1388-2457
VL - 143
SP - 172
EP - 181
JO - Clinical Neurophysiology
JF - Clinical Neurophysiology
ER -