![]() ![]() ![]() However, it is difficult to delineate the EZ directly and accurately. Accurate localization of the epileptogenic zone (EZ) is crucial for the surgical prognosis of medically refractory epilepsy ( 1). Surgery is one of the treatment options for medically refractory epilepsy. Clinical application of HIs as an indicator may facilitate localization of the EZ. If the n-HI of the brain region was >1.35, it was more likely to be an epileptogenic region. Sensitivity and specificity of HI based on ripple rates (n-HI) for EZ localization were 90% and 79.58%, respectively. Our results showed that the HI in regions of interest (ROIs) was significantly higher than in contra-ROIs. NEW & NOTEWORTHY We proposed the scalp-high-frequency oscillation (HFO) index (HI) as a quantitative assessment method for scalp HFOs to locate the epileptogenic zone (EZ). However, few scalp HFOs were recorded when the EZ was located in the medial cortex region. HI may contribute to the implantation strategy of invasive electrodes. The sensitivity and specificity of n-HI for the localization of the EZ were 90% and 79.58%, respectively, suggesting that n-HI was valuable in localizing the EZ. The HIs based on the ripple numbers (n-HI) and spectral power (s-HI) were significantly higher in the ROI than in the contra-ROI ( P = 0.012, P = 0.003), indicating that HIs contributed to the lateralization of EZ. We labeled the brain lobes involved in the EZ as regions of interest (ROIs). The calculation was based on the numbers and spectral power of scalp HFOs automatically detected. This method was called the “scalp-HFO index” (HI) and calculated in both the EZ and non-EZ. There were few quantitative measures for scalp HFOs, so we proposed a new method to quantify and analyze scalp HFOs. However, a large number of studies on HFOs stem from intracranial research. High-frequency oscillations (HFOs) are considered to be promising biological markers for the EZ. Confirmation of laterality is required when the preoperative evaluation limits the EZ to bilateral anterior temporal lobes or bilateral frontal lobes. During the noninvasive evaluation phase for refractory epilepsy, the localization of the epileptogenic zone (EZ) is essential for the surgical protocols. ![]()
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