Fig. 4: The relationship between HFO and clinical SOZ and outcome.

a, c The agreement plot of the amount of HFO (%) coming from SOZ before and after pseudo-HFO elimination. The subjects with good outcomes (Engel class I, II) were color-coded with green, while those subjects with poor outcomes (Engel class III and IV) were color-coded with gray. b, d The box plot of SOZ localization accuracy using the HFO distribution in both IOM and EMU scenarios for subjects with good surgical outcomes. e, f The relationship of HFO distribution and the surgical target region: The percentage of HFOs, Rs, and FRs coming from the target region of surgical therapy (resection volume: RV) is calculated for both IOM and EMU data. All HFOs, Rs, and FRs are predicting the outcome of surgeries in both IOM (good outcome: HFO: 64%, R: 74% FR: 76% and bad outcome: HFO: 33%, R: 40%, FR: 39%) and EMU (good outcome: HFO: 78%, R: 76%, FR: 84% and bad outcome: HFO: 26%, R: 25%, FR: 4%) scenarios. Sample sizes (n): IOM HFO (good outcome: n = 19, bad outcome: n = 4), IOM R (good outcome: n = 19, bad outcome: n = 4), IOM FR (good outcome: n = 14, bad outcome: n = 3), EMU HFO (good outcome: n = 17, bad outcome: n = 3), EMU R (good outcome: n = 17, bad outcome: n = 3), EMU FR (good outcome: n = 11, bad outcome: n = 1). The error bars represent the median with 25th and 75th percentiles. All values in this figure are presented as mean ± standard deviation (std). * Suggests significance at 0.05 level, ** suggests significance at 0.01 level, and *** suggests significance at 0.001 level. IOM intraoperative monitoring, EMU epilepsy monitoring unit, HFO high-frequency oscillation, R ripple, FR fast ripple, SOZ seizure onset zone, RV resected volume.