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Diagnostic value of high-frequency oscillations for the epileptogenic zone: A systematic review and meta-analysis

2022; Elsevier BV; Volume: 99; Linguagem: Inglês

10.1016/j.seizure.2022.05.003

1532-2688

Yangshuo Wang, Jinshan Xu, Tinghong Liu, Feng Chen, Daiwen Chen, Yuan Liu, Feng Zhai, Shuli Liang,

Drug Transport and Resistance Mechanisms

Delineation of the epileptogenic zone (EZ) is crucial during resective surgery in patients with epilepsy. In recent years, high-frequency oscillations, including fast ripples and ripples, have been considered promising biomarkers of the EZ. The objective of this study was to perform a systematic review and meta-analysis to evaluate the diagnostic accuracy of fast ripples and ripples in identifying EZs.The PubMed, Embase, and Cochrane databases were searched systematically. The review process followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. A bivariate mixed-effects regression approach was used to obtain summary estimates of the sensitivity and specificity of fast ripples and ripples.Thirteen studies were included in this review (12 for fast ripples and eight for ripples). Fast ripples had a pooled sensitivity of 0.80 (95% confidence interval [CI], 0.62-0.91), a specificity of 0.72 (95% CI, 0.55-0.85), and a summary area under the curve of 0.82 (95% CI, 0.79-0.86). The threshold effect was detected for ripples, and the summary area under the curve was 0.75 (95% CI, 0.71-0.79), with a sensitivity of 0.38 (95% CI, 0.18-0.64) and specificity of 0.90 (95% CI, 0.70-0.97).Fast ripples are a biomarker of the EZ with moderate diagnostic accuracy; in contrast, ripples are not as effective.