High-frequency oscillations (HFOs) encompass ripples (80 Hz–200 Hz) and fast ripples (200 Hz–600 Hz), serving as a promising biomarker for localizing the epileptogenic zone in epilepsy. Spontaneous fast ripples are always pathological, while ripples may be physiological or pathological. Distinguishing physiological from pathological ripples is important not only for designating epileptogenic brain regions, but also for investigations that study ripples in the context of memory encoding, consolidation, and recall in patients with epilepsy. Many studies have sought to identify distinguishing features between pathological and physiological ripples over the past two decades. Physiological and pathological ripples differ with respect to their spatial location, cellular mechanisms, morphology, and coupling with background electroencephalographic activity. Retrospective studies have demonstrated that differentiating between pathological and physiological ripples can improve surgical outcome prediction. In this review, we summarize the characteristics, differences, and applications of pathological and physiological HFOs and discuss strategies for their clinical translation.

高频振荡 (HFO) 包括波纹 (80 Hz–200 Hz) 和快速波纹 (200 Hz–600 Hz)，可作为定位癫痫致痫区的有前途的生物标志物。自发的快速波纹总是病理性的，而波纹可能是生理性的，也可能是病理性的。区分生理性波纹和病理性波纹不仅对于指定致癫痫的大脑区域很重要，而且对于研究癫痫患者记忆编码、巩固和回忆背景下的波纹的研究也很重要。在过去的二十年里，许多研究都试图找出病理和生理波动之间的区别特征。生理和病理波纹在空间位置、细胞机制、形态以及与背景脑电图活动的耦合方面有所不同。回顾性研究表明，区分病理和生理波动可以改善手术结果的预测。在这篇综述中，我们总结了病理性和生理性 HFO 的特点、差异和应用，并讨论了其临床转化策略。