TY - JOUR T1 - Frequency band coupling with high-frequency activities during seizures shifts from θ band in tonic phase to δ band in clonic phase JF - bioRxiv DO - 10.1101/2021.10.06.463288 SP - 2021.10.06.463288 AU - Hiroaki Hashimoto AU - Hui Ming Khoo AU - Takufumi Yanagisawa AU - Naoki Tani AU - Satoru Oshino AU - Masayuki Hirata AU - Haruhiko Kishima Y1 - 2021/01/01 UR - http://biorxiv.org/content/early/2021/10/07/2021.10.06.463288.abstract N2 - Objective To clarify variations in the relationship between high-frequency activities (HFAs) and low-frequency bands from the tonic to the clonic phase in focal to bilateral tonic-clonic seizures (FBTCS), using phase-amplitude coupling.Methods This retrospective study enrolled six patients with drug-resistant focal epilepsy who underwent intracranial electrode placement for presurgical invasive electroencephalography at Osaka University Hospital (July 2018–July 2019). We used intracranial electrodes to record seizures in focal epilepsy (11 FBTCS). The magnitude of synchronization index (SIm) and receiver-operating characteristic (ROC) analysis were used to analyze the coupling between HFA amplitude (80–250 Hz) and lower frequencies phase.Results The θ (4–8 Hz)-HFA SIm peaked in the tonic phase, whereas the δ (2–4 Hz)-HFA SIm peaked in the clonic phase. ROC analysis indicated that the δ-HFA SIm discriminated well the clonic from the tonic phase.Conclusions The main low-frequency band modulating the HFA shifted from the θ band in the tonic phase to the δ band in the clonic phase.Significance In FBTCS, low-frequency band coupling with HFA amplitude varies temporally. Especially, the δ band is specific to the clonic phase. These results suggest dynamically neurophysiological changes in the thalamus or basal ganglia throughout FBTCS.HighlightsThe θ band (4–8 Hz) was mainly coupled with high-frequency activity (HFA) in the tonic phase of focal to bilateral tonic-clonic seizures (FBTCS).The δ band (2–4 Hz) was mainly coupled with HFA in the clonic phase of FBTCS.The magnitude of the synchronization index related to δ-HFA phase-amplitude coupling discriminated well the clonic from the tonic phase.Competing Interest StatementThe authors have declared no competing interest.AUCarea under the curveEEGelectroencephalogramFBTCSfocal to bilateral tonic-clonic seizuresFIASfocal impaired awareness seizureFWEfamily-wise errorHFAhigh-frequency activityHFOhigh-frequency oscillationiEEGintracranial electroencephalogramMRImagnetic resonance imagingPACphase-amplitude couplingROCreceiver-operating characteristicSDstandard deviationSIsynchronization indexSImmagnitude of SISImbbootstrapped SImSIppreferred phase of synchronizationSOZseizure onset zone3Dthree-dimensional ER -