Objective: Interictal discharges (IIDs) and high frequency oscillations (HFOs) are neurophysiologic biomarkers of epilepsy. In this study, we use custom poly(3,4-ethylenedioxythiophene) polystyrene sulfonate (PEDOT:PSS) microelectrodes to better understand their microscale dynamics. Methods: Electrodes with spatial resolution down to 50μm were used to record intraoperatively in 30 subjects. For IIDs, putative spatiotemporal paths were generated by peak-tracking, followed by clustering. For HFOs, repeating patterns were elucidated by clustering similar time windows. Fast events, consistent with multi-unit activity (MUA), were covaried with either IIDs or HFOs. Results: IIDs seen across the entire array were detected in 93% of subjects. Local IIDs, observed across <50% of the array, were seen in 53% of subjects. IIDs appeared to travel across the array in specific paths, and HFOs appeared in similar repeated spatial patterns. Finally, microseizure events were identified spanning 50-100μm. HFOs covaried with MUA, but not with IIDs. Conclusions: Overall, these data suggest micro-domains of irritable cortex that form part of an underlying pathologic architecture that contributes to the seizure network. Significance: Microelectrodes in cases of human epilepsy can reveal dynamics that are not seen by conventional electrocorticography and point to new possibilities for their use in the diagnosis and treatment of epilepsy.

中文翻译：

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癫痫电生理标志物的微观动力学

目的：壁间放电（IIDs）和高频振荡（HFOs）是癫痫的神经生理生物标志物。在这项研究中，我们使用定制的聚（3,4-乙撑二氧噻吩）聚苯乙烯磺酸盐（PEDOT：PSS）微电极来更好地了解它们的微观动力学。方法：使用空间分辨率低至50μm的电极在30名受试者中进行术中记录。对于IID，通过峰跟踪并随后进行聚类来生成假定的时空路径。对于HFO，通过对相似的时间窗口进行聚类来阐明重复模式。与多单位活动（MUA）一致的快速事件与IID或HFO协变。结果：在整个阵列中看到的IID在93％的受试者中被检测到。在不到50％的阵列中观察到的局部IID在53％的受试者中可见。IID似乎以特定的路径横穿阵列，而HFO则以类似的重复空间模式出现。最终，确定了微发作事件，范围为50-100μm。HFO与MUA协变量，但与IID不协变量。结论：总体而言，这些数据表明，易怒皮层的微区构成了有助于癫痫发作网络的潜在病理结构的一部分。启示：在人类癫痫病例中，微电极可以揭示传统的皮质描记术所看不到的动力学，并为在癫痫的诊断和治疗中使用它们提供了新的可能性。这些数据表明，易怒皮层的微区构成了有助于癫痫发作网络的潜在病理结构的一部分。启示：在人类癫痫病例中，微电极可以揭示传统的皮质描记术所看不到的动力学，并为在癫痫的诊断和治疗中使用它们提供了新的可能性。这些数据表明，易怒皮层的微区构成了有助于癫痫发作网络的潜在病理结构的一部分。启示：在人类癫痫病例中，微电极可以揭示传统的皮质描记术所看不到的动力学，并为在癫痫的诊断和治疗中使用它们提供了新的可能性。