{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T03:30:07Z","timestamp":1792553407368,"version":"4.5.0"},"reference-count":70,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,6,3]],"date-time":"2022-06-03T00:00:00Z","timestamp":1654214400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["JA 1725\/4-1"],"award-info":[{"award-number":["JA 1725\/4-1"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Rationale<\/jats:title><jats:p>High frequency oscillations (HFO; ripples = 80\u2013200, fast ripples 200\u2013500 Hz) are promising epileptic biomarkers in patients with epilepsy. However, especially in temporal epilepsies differentiation of epileptic and physiological HFO activity still remains a challenge. Physiological sleep-spindle-ripple formations are known to play a role in slow-wave-sleep memory consolidation. This study aimed to find out if higher rates of mesial-temporal spindle-ripples correlate with good memory performance in epilepsy patients and if surgical removal of spindle-ripple-generating brain tissue correlates with a decline in memory performance. In contrast, we hypothesized that higher rates of overall ripples or ripples associated with interictal epileptic spikes correlate with poor memory performance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with epilepsy implanted with electrodes in mesial-temporal structures, neuropsychological memory testing and subsequent epilepsy surgery were included. Ripples and epileptic spikes were automatically detected in intracranial EEG and sleep-spindles in scalp EEG. The coupling of ripples to spindles was automatically analyzed. Mesial-temporal spindle-ripple rates in the speech-dominant-hemisphere (left in all patients) were correlated with verbal memory test results, whereas ripple rates in the non-speech-dominant hemisphere were correlated with non-verbal memory test performance, using Spearman correlation).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Intracranial EEG and memory test results from 25 patients could be included. All ripple rates were significantly higher in seizure onset zone channels (<jats:italic>p<\/jats:italic> &amp;lt; 0.001). Patients with pre-surgical verbal memory impairment had significantly higher overall ripple rates in left mesial-temporal channels than patients with intact verbal memory (Mann\u2013Whitney-U-Test: <jats:italic>p<\/jats:italic> = 0.039). Spearman correlations showed highly significant negative correlations of the pre-surgical verbal memory performance with left mesial-temporal spike associated ripples (r<jats:sub>s<\/jats:sub> = \u22120.458; <jats:italic>p<\/jats:italic> = 0.007) and overall ripples (r<jats:sub>s<\/jats:sub> = \u22120.475; <jats:italic>p<\/jats:italic> = 0.006). All three ripple types in right-sided mesial-temporal channels did not correlate with pre-surgical nonverbal memory. No correlation for the difference between post- and pre-surgical memory and pre-surgical spindle-ripple rates was seen in patients with left-sided temporal or mesial-temporal surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>This study fails to establish a clear link between memory performance and spindle ripples. This highly suggests that spindle-ripples are only a small portion of physiological ripples contributing to memory performance. More importantly, this study indicates that spindle-ripples do not necessarily compromise the predictive value of ripples in patients with temporal epilepsy. The majority of ripples were clearly linked to areas with poor memory function.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2022.876024","type":"journal-article","created":{"date-parts":[[2022,6,3]],"date-time":"2022-06-03T07:04:58Z","timestamp":1654239898000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Mesial-Temporal Epileptic Ripples Correlate With Verbal Memory Impairment"],"prefix":"10.3389","volume":"13","author":[{"given":"Jonas Christian","family":"Bruder","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathrin","family":"Wagner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Lachner-Piza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerstin Alexandra","family":"Klotz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Schulze-Bonhage","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Jacobs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,6,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"314","DOI":"10.1056\/NEJM200002033420503","article-title":"Early identification of refractory epilepsy","volume":"342","author":"Kwan","year":"2000","journal-title":"New England J Med."},{"key":"B2","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1111\/j.1750-3639.2002.tb00436.x","article-title":"Ammon's horn sclerosis: a maldevelopmental disorder associated with temporal lobe epilepsy","volume":"12","author":"Bl\u00fcmcke","year":"2002","journal-title":"Brain Pathol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"662","DOI":"10.1016\/j.wneu.2016.12.074","article-title":"Prevalence and Incidence of Drug-Resistant Mesial Temporal Lobe Epilepsy in the United States","volume":"99","author":"Asadi-Pooya","year":"2017","journal-title":"World Neurosurg."},{"key":"B4","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1056\/NEJM200108023450501","article-title":"Effectiveness and efficiency of surgery for temporal lobe epilepsy study group. 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