Clin Neurophysiol. 2022 Aug 30:S1388-2457(22)00867-7. doi: 10.1016/j.clinph.2022.08.014. Online ahead of print.
ABSTRACT
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 (χ2(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.
PMID:36115810 | DOI:10.1016/j.clinph.2022.08.014
