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Pathological and Physiological High-frequency Oscillations on Electroencephalography in Patients with Epilepsy

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Abstract

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.

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Acknowledgments

This review was supported by the National Natural Science Foundation of China (82171437 and 81971207).

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  1. Hongyi Ye and Cong Chen contributed equally to this review.

Authors and Affiliations

  1. Department of Neurology, Epilepsy Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, China

    Hongyi Ye, Cong Chen & Shuang Wang

  2. Department of Neurology, State University of New York Downstate, Brooklyn, NY, 11203, USA

    Shennan A. Weiss

  3. Department of Physiology and Pharmacology, State University of New York Downstate, Brooklyn, NY, 11203, USA

    Shennan A. Weiss

  4. Department of Neurology, New York City Health + Hospitals/Kings County, Brooklyn, NY, 11203, USA

    Shennan A. Weiss

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Ye, H., Chen, C., Weiss, S.A. et al. Pathological and Physiological High-frequency Oscillations on Electroencephalography in Patients with Epilepsy. Neurosci. Bull. (2023). https://doi.org/10.1007/s12264-023-01150-6

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