ObjectiveIn the era of stereoelectroencephalography (SEEG), many studies have been devoted to understanding the role of interictal high‐frequency oscillations. High‐frequency activity (HFA) at seizure onset has been identified as a marker of epileptogenic zone. We address the physiological significance of ictal HFAs and their relation to clinical semiology.MethodsWe retrospectively identified patients with pure focal primary motor epilepsy. We selected only patients in whom SEEG electrodes were optimally placed in the motor cortex as confirmed by electrical stimulation. Based on these narrow inclusion criteria, we extensively studied 5 patients (3 males and 2 females, mean age = 22.4 years) using time–frequency analysis and time correlation with motor signs onset.ResultsA total of 157 analyzable seizures were recorded in 5 subjects. The first 2 subjects had tonic or clonic semiology with rare secondary generalization. Subject 3 had atonic onset followed by clonic hand/arm flexion. Subject 4 had clusters of tonic and atonic facial movements. Subject 5 had upper extremity tonic movements. The median frequency of the fast activity extracted from the Epileptogenic Zone Fingerprint pipeline in the first 4 subjects was 76 Hz (interquartile range = 21.9Hz). Positive motor signs did not occur concomitantly with high gamma activity developing in the motor cortex. Motor signs began at the end of HFAs.InterpretationThis study supports the hypothesis of an inhibitory effect of ictal HFAs. The frequency range in the gamma band was associated with the direction of the clinical output effect. Changes from inhibitory to excitatory effect occurred when discharge frequency dropped to low gamma or beta. ANN NEUROL 2024

中文翻译：

---

癫痫发作时的高频活动是否具有抑制作用？运动皮层癫痫发作的立体脑电图研究

目的在立体脑电图（SEEG）时代，许多研究致力于了解发作间期高频振荡的作用。癫痫发作时的高频活动（HFA）已被确定为癫痫发生区的标志。我们探讨了发作期 HFA 的生理意义及其与临床症状学的关系。方法我们回顾性鉴定了纯局灶性原发性运动性癫痫患者。我们仅选择了经电刺激证实 SEEG 电极最佳放置在运动皮层的患者。基于这些狭窄的纳入标准，我们使用时频分析和与运动体征发作的时间相关性对 5 名患者（3 名男性和 2 名女性，平均年龄 = 22.4 岁）进行了广泛研究。结果 5 名受试者总共记录了 157 次可分析的癫痫发作。前 2 名受试者具有强直或阵挛症状，但很少有二次概括。受试者 3 出现失张力发作，随后出现阵挛性手/臂屈曲。受试者 4 有一系列强直和失张力的面部动作。受试者 5 有上肢强直运动。从前 4 名受试者的致痫区指纹管道中提取的快速活动的中位频率为 76 Hz（四分位距 = 21.9Hz）。积极的运动体征并不与运动皮层中高伽玛活动的发展同时发生。运动症状在 HFA 结束时开始。解释本研究支持发作期 HFA 具有抑制作用的假设。伽玛波段的频率范围与临床输出效应的方向相关。当放电频率降至低伽玛或贝塔时，就会发生从抑制作用到兴奋作用的变化。安神经学 2024