The Role of Delta-Modulated High Frequency Oscillations in Seizure State Classification

High frequency oscillations (HFOs), which collectively refer to ripples (80-200 Hz) and fast ripples (>200 Hz), have been implicated as key players in epileptogenesis. However, their presence alone is not in and of itself indicative of a pathological brain state. Rather, spatial origins as well as coexistence with other neural rhythms are essential components in defining pathological HFOs. This study investigates how the phase of the delta rhythm (0.5-4 Hz) modulates the amplitude of HFOs during a seizure episode. Seven seizures recorded from three patients presenting with intractable temporal lobe epilepsy were obtained via intracranial electroencephalography (iEEG) from a 64-electrode grid. Delta modulation of the HFO rhythms was found to emerge at seizure onset and termination regardless of the dynamics present within the seizure episode itself. Moreover, the differences between delta modulating the ripple or fast ripple may be due to the sleep stage of the patient when the seizures were being recorded. Further studies exploring how this modulation changes in space across the grid may also highlight additional properties of this phenomenon. Its temporal pattern suggests that it is a potential iEEG-based biomarker for seizure state classification.