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. Author manuscript; available in PMC: 2024 Dec 1.
Published in final edited form as: Epilepsia. 2023 Mar 22;64(Suppl 3):S25–S36. doi: 10.1111/epi.17578

TABLE 1.

Overview of passive and active markers of cortical excitability.

Passive Active


Spikes HFOs Background EEG Single pulse Train of pulses
Current use Clinical evaluation of the irritative zone for surgical planning Research Research Trigger clinical seizures for surgical planning
What is measured Visual identification of spikes
Spike quantity and network
Visual identification of HFOs
HFO quantity and network
Spectral measures
Connectivity measures
CCEP amplitude
Triggered epileptiform responses
Connectivity measures
Visual identification of seizure onset
What is localized Spike zone HFO zone Not established Not established Seizure onset zone
Monitoring over time Strong modulation by brain states: frequency, amplitude, and propagation variable across sleep– wake, circadian, and multidien cycles Not established Not established
Modulation by ASMs Expected decrease Expected decrease Not established Expected decrease in excitability Expected increase in seizure threshold

Abbreviations: ASM, antiseizure medication; CCEP, corticocortical evoked potential; EEG, electroencephalogram; HFO, high-frequency oscillation.