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- W3208734644 abstract "Objective: Phase-amplitude coupling between high-frequency (>150 Hz) and delta (3-4 Hz) oscillations - modulation index (MI) - is a promising, objective biomarker of epileptogenicity. We determined whether sevoflurane anesthesia preferentially enhances this metric within the epileptogenic zone. Methods: This is an observational study of intraoperative electrocorticography data from 621 electrodes chronically implanted into eight patients with drug-resistant, focal epilepsy. All patients were anesthetized with sevoflurane during resective surgery, which subsequently resulted in seizure control. We classified removed and retained brain sites as epileptogenic and non-epileptogenic, respectively. Mixed model analysis determined which anesthetic stage optimized MI-based classification of epileptogenic sites. Results: MI increased as a function of anesthetic stage, ranging from baseline (i.e., oxygen alone) to 2 minimum alveolar concentration (MAC) of sevoflurane, preferentially at sites showing higher initial MI values. This phenomenon was accentuated just prior to sevoflurane reaching 2 MAC, at which time, the odds of a site being classified as epileptogenic were enhanced by 86.6 times for every increase of 1 MI. Conclusions: Intraoperative MI best localized the epileptogenic zone immediately before sevoflurane reaching 2 MAC in this small cohort of patients. Significance: Prospective, large cohort studies are warranted to determine whether sevoflurane anesthesia can reduce the need for extraoperative, invasive evaluation." @default.
- W3208734644 created "2021-11-08" @default.
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- W3208734644 date "2021-10-26" @default.
- W3208734644 modified "2023-10-15" @default.
- W3208734644 title "Sevoflurane-Based Enhancement of Phase-Amplitude Coupling and Localization of the Epileptogenic Zone" @default.
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- W3208734644 doi "https://doi.org/10.1101/2021.10.21.21265330" @default.
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