Chronological changes in phase-amplitude coupling during epileptic seizures in temporal lobe epilepsy

Tetsuya Ueda; Yasushi Iimura; Takumi Mitsuhashi; Hiroharu Suzuki; Yao Miao; Kazuki Nishioka; Samantha Tamrakar; Ryousuke Matsui; Toshihisa Tanaka; Hiroshi Otsubo; Hidenori Sugano; Akihide Kondo

doi:10.1016/j.clinph.2023.01.014

Chronological changes in phase-amplitude coupling during epileptic seizures in temporal lobe epilepsy

Clin Neurophysiol. 2023 Apr:148:44-51. doi: 10.1016/j.clinph.2023.01.014. Epub 2023 Feb 6.

Authors

Affiliations

¹ Department of Neurosurgery, Epilepsy Center, Juntendo University, Tokyo, Japan. Electronic address: tueda@juntendo.ac.jp.
² Department of Neurosurgery, Epilepsy Center, Juntendo University, Tokyo, Japan. Electronic address: yiimura@juntendo.ac.jp.
³ Department of Neurosurgery, Epilepsy Center, Juntendo University, Tokyo, Japan. Electronic address: tmituha@juntendo.ac.jp.
⁴ Department of Neurosurgery, Epilepsy Center, Juntendo University, Tokyo, Japan. Electronic address: hi-suzuki@juntendo.ac.jp.
⁵ Department of Electronic and Information Engineering, Tokyo University of Agriculture and Technology, Tokyo, Japan. Electronic address: miao@sip.tuat.ac.jp.
⁶ Department of Neurosurgery, Epilepsy Center, Juntendo University, Tokyo, Japan. Electronic address: k-nishioka@juntendo.ac.jp.
⁷ Department of Neurosurgery, Epilepsy Center, Juntendo University, Tokyo, Japan. Electronic address: s.tamrakar.rr@juntendo.ac.jp.
⁸ Department of Electronic and Information Engineering, Tokyo University of Agriculture and Technology, Tokyo, Japan. Electronic address: matsui17@sip.tuat.ac.jp.
⁹ Department of Electronic and Information Engineering, Tokyo University of Agriculture and Technology, Tokyo, Japan. Electronic address: tanakat@cc.tuat.ac.jp.
¹⁰ Department of Neurosurgery, Epilepsy Center, Juntendo University, Tokyo, Japan; Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada. Electronic address: hiroshi.otsubo@sickkids.ca.
¹¹ Department of Neurosurgery, Epilepsy Center, Juntendo University, Tokyo, Japan. Electronic address: debo@juntendo.ac.jp.
¹² Department of Neurosurgery, Epilepsy Center, Juntendo University, Tokyo, Japan. Electronic address: knd-aki@juntendo.ac.jp.

PMID: 36796285
DOI: 10.1016/j.clinph.2023.01.014

Abstract

Objective: To analyze chronological changes in phase-amplitude coupling (PAC) and verify whether PAC analysis can diagnose epileptogenic zones during seizures.

Methods: We analyzed 30 seizures in 10 patients with mesial temporal lobe epilepsy who had ictal discharges with preictal spiking followed by low-voltage fast activity patterns on intracranial electroencephalography. We used the amplitude of two high-frequency bands (ripples: 80-200 Hz, fast ripples: 200-300 Hz) and the phase of three slow wave bands (0.5-1 Hz, 3-4 Hz, and 4-8 Hz) for modulation index (MI) calculation from 2 minutes before seizure onset to seizure termination. We evaluated the accuracy of epileptogenic zone detection by MI, in which a combination of MI was better for diagnosis and analyzed patterns of chronological changes in MI during seizures.

Results: MI_{Ripples/3-4 Hz} and MI_{Ripples/4-8 Hz} in the hippocampus were significantly higher than those in the peripheral regions from seizure onset. Corresponding to the phase on intracranial electroencephalography, MI_{Ripples/3-4 Hz} decreased once and subsequently increased again. MI_{Ripples/4-8 Hz} showed continuously high values.

Conclusions: Continuous measurement of MI_{Ripples/3-4 Hz} and MI_{Ripples/4-8 Hz} could help identify epileptogenic zones.

Significance: PAC analysis of ictal epileptic discharges can help epileptogenic zone identification.

Keywords: High-frequency oscillations; Ictal analysis; Modulation index; Phase-amplitude coupling; Seizure detection; Temporal lobe epilepsy.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Electrocorticography
Electroencephalography
Epilepsy, Temporal Lobe* / diagnosis
Hippocampus
Humans
Seizures / diagnosis