{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T15:02:01Z","timestamp":1780498921058,"version":"3.54.1"},"reference-count":38,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2017,9,26]],"date-time":"2017-09-26T00:00:00Z","timestamp":1506384000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K23 NS094633\u201001A1"],"award-info":[{"award-number":["K23 NS094633\u201001A1"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Differentiating pathologic and physiologic high\u2010frequency oscillations (<jats:styled-content style=\"fixed-case\">HFO<\/jats:styled-content>s) is challenging. In patients with focal epilepsy, <jats:styled-content style=\"fixed-case\">HFO<\/jats:styled-content>s occur during the transitional periods between the up and down state of slow waves. The preferred phase angles of this form of phase\u2010event amplitude coupling are bimodally distributed, and the ripples (80\u2013150\u00a0Hz) that occur during the up\u2010down transition more often occur in the seizure\u2010onset zone (<jats:styled-content style=\"fixed-case\">SOZ<\/jats:styled-content>). We investigated if bimodal ripple coupling was also evident for faster sleep oscillations, and could identify the <jats:styled-content style=\"fixed-case\">SOZ<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using an automated ripple detector, we identified ripple events in 40\u201360\u00a0min intracranial electroencephalography (<jats:styled-content style=\"fixed-case\">iEEG<\/jats:styled-content>) recordings from 23 patients with medically refractory mesial temporal lobe or neocortical epilepsy. The detector quantified epochs of sleep oscillations and computed instantaneous phase. We utilized a ripple phasor transform, ripple\u2010triggered averaging, and circular statistics to investigate phase event\u2010amplitude coupling.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We found that at some individual recording sites, ripple event amplitude was coupled with the sleep oscillatory phase and the preferred phase angles exhibited two distinct clusters (p\u00a0&lt;\u00a00.05). The distribution of the pooled mean preferred phase angle, defined by combining the means from each cluster at each individual recording site, also exhibited two distinct clusters (p\u00a0&lt;\u00a00.05). Based on the range of preferred phase angles defined by these two clusters, we partitioned each ripple event at each recording site into two groups: depth <jats:styled-content style=\"fixed-case\">iEEG<\/jats:styled-content> peak\u2010trough and trough\u2010peak. The mean ripple rates of the two groups in the <jats:styled-content style=\"fixed-case\">SOZ<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">non\u2010SOZ (NSOZ)<\/jats:styled-content> were compared. We found that in the frontal (spindle, p\u00a0=\u00a00.009; theta, p\u00a0=\u00a00.006, slow, p\u00a0=\u00a00.004) and parietal lobe (theta, p\u00a0=\u00a00.007, delta, p\u00a0=\u00a00.002, slow, p\u00a0=\u00a00.001) the <jats:styled-content style=\"fixed-case\">SOZ<\/jats:styled-content> incidence rate for the ripples occurring during the trough\u2010peak transition was significantly increased.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Phase\u2010event amplitude coupling between ripples and sleep oscillations may be useful to distinguish pathologic and physiologic events in patients with frontal and parietal <jats:styled-content style=\"fixed-case\">SOZ<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/epi.13912","type":"journal-article","created":{"date-parts":[[2017,9,26]],"date-time":"2017-09-26T08:43:20Z","timestamp":1506415400000},"page":"1972-1984","source":"Crossref","is-referenced-by-count":57,"title":["Bimodal coupling of 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