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The aim of this study was to clarify the effect of a stable concentration of propofol on interictal high\u2010frequency oscillations (HFOs), which may contribute to identifying the epileptogenic zone intraoperatively for resection surgery.<\/jats:p><jats:p><jats:italic><jats:bold>Methods<\/jats:bold><\/jats:italic>. Nine patients with drug\u2010resistant focal epilepsy who underwent invasive pre\u2010surgical evaluation with chronic subdural electrodes were recruited. Five\u2010minute electrocorticograms during wakefulness, slow\u2010wave sleep, and under a stable brain concentration of propofol were recorded with the same electrodes. In each patient, 1\u201310 pairs of electrodes were selected for both electrodes with EEG changes within 5 seconds from the ictal onset (ictal pattern for 5 seconds [IP5]) and those outside the area of IP5 with no interictal epileptiform discharges (non\u2010epileptiform [nEPI]). The numbers of ripples (80\u2010250\u00a0Hz) and fast ripples (&gt;250\u00a0Hz) were measured semi\u2010automatically using an established algorithm. Statistical testing was performed with a mixed effect model.<\/jats:p><jats:p><jats:italic><jats:bold>Results<\/jats:bold><\/jats:italic>. Thirty\u2010seven pairs of electrodes from nine patients were analysed for IP5 and 29 pairs from seven patients were analysed for nEPI. The numbers of HFOs differed between the areas (IP5 and nEPI) and among the conditions (wakefulness, slow\u2010wave sleep, propofol anaesthesia) (all p &lt;0.01). The HFO occurrence rates were significantly higher for IP5 than those for nEPI in all conditions (for both ripples and fast ripples in all conditions; p &lt;0.01).<\/jats:p><jats:p><jats:italic><jats:bold>Significance<\/jats:bold><\/jats:italic>. The occurrence rates of HFOs for IP5 were significantly higher than those for nEPI under propofol anaesthesia. These are fundamental findings for intraoperative HFO analysis, however, the following limitations should be considered: physiological HFOs could not be completely differentiated from pathological HFOs; in order to apply an HFO detector, an appropriate cut\u2010off threshold is needed; an artefact of the impulse response filter appears as an HFO; and the series was comprised of a small number of heterogeneous patients.<\/jats:p>","DOI":"10.1684\/epd.2021.1264","type":"journal-article","created":{"date-parts":[[2021,5,13]],"date-time":"2021-05-13T13:30:49Z","timestamp":1620912649000},"page":"299-312","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Effects of a stable concentration of propofol on interictal high\u2010frequency oscillations in drug\u2010resistant epilepsy"],"prefix":"10.1002","volume":"23","author":[{"given":"Taku","family":"Inada","sequence":"first","affiliation":[{"name":"Department of Neurosurgery 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