Ictal fast activity chirps as markers of the epileptogenic zone

• DOI: 10.1111/epi.17995
• Publication Date: 2024-04-30T12:09:14Z
• Authors: Roberta Di Giacomo; Alessandra Burini; Daniela Chiarello; Veronica Pelliccia; Francesco Deleo; Rita Garbelli; Marco de Curtis; Laura Tassi; Vadym Gnatkovsky
• Keywords: Stereoelectroencephalography; Concordance

Abstract The identification of the epileptogenic zone (EZ) boundaries is crucial for effective focal epilepsy surgery. We verify value a neurophysiological biomarker ictogenesis, characterized by low‐voltage fast‐activity ictal pattern (chirp) recorded with intracerebral electrodes during invasive presurgical monitoring (stereoelectroencephalography [SEEG]). frequency content SEEG signals was retrospectively analyzed semiautomatic software in 176 consecutive patients epilepsies that either were cryptogenic or presented discordant anatomoelectroclinical findings. Fast activity seizure patterns spectrographic features chirps confirmed computer‐assisted analysis 95.4% who heterogeneous etiologies and diverse lobar location EZ. Statistical demonstrated (1) correlation between outcome concordance sublobar regions included EZ defined visual chirp‐generating regions, (2) high contact‐by contact 68 Engel class Ia outcome, (3) discordance chirp visually outlined correlated worse outcome. Seizure confirms fast reproducible group undergoing SEEG.