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Background: We sought to determine if ripple oscillations (80-120Hz),detected in intracranial EEG (iEEG) recordings of epilepsy patients, correlatewith an enhancement or disruption of verbal episodic memory encoding. Methods:We defined ripple and spike events in depth iEEG recordings during listlearning in 107 patients with focal epilepsy. We used logistic regressionmodels (LRMs) to investigate the relationship between the occurrence of rippleand spike events during word presentation and the odds of successful wordrecall following a distractor epoch, and included the seizure onset zone (SOZ)as a covariate in the LRMs. Results: We detected events during 58,312 wordpresentation trials from 7,630 unique electrode sites. The probability ofripple on spike (RonS) events was increased in the seizure onset zone (SOZ,p<0.04). In the left temporal neocortex RonS events during word presentationcorresponded with a decrease in the odds ratio (OR) of successful recall,however this effect only met significance in the SOZ (OR of word recall 0.71,95% CI: 0.59-0.85, n=158 events, adaptive Hochberg p<0.01). Ripple onoscillation events (RonO) that occurred in the left temporal neocortex non-SOZalso correlated with decreased odds of successful recall (OR 0.52, 95% CI:0.34-0.80, n=140, adaptive Hochberg , p<0.01). Spikes and RonS that occurredduring word presentation in the left middle temporal gyrus during wordpresentation correlated with the most significant decrease in the odds ofsuccessful recall, irrespective of the location of the SOZ (adaptive Hochberg,p<0.01). Conclusion: Ripples and spikes generated in left temporal neocortexare associated with impaired verbal episodic memory encoding.

Ripple oscillations in the left temporal neocortex are associated with impaired verbal episodic memory encoding