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Stimulation better targets fast-ripple generating networks in super responders to the responsive neurostimulator system.
Weiss, Shennan Aibel; Eliashiv, Dawn; Stern, John; Rubinstein, Daniel; Fried, Itzhak; Wu, Chengyuan; Sharan, Ashwini; Engel, Jerome; Staba, Richard; Sperling, Michael R.
Afiliación
  • Weiss SA; Department Of Neurology, State University of New York Downstate, Brooklyn, New York, 11203, USA.
  • Eliashiv D; Department of Physiology and Pharmacology, State University of New York Downstate, Brooklyn, New York, 11203, USA.
  • Stern J; Department of Neurology, New York City Health + Hospitals/Kings County, Brooklyn, New York, USA.
  • Rubinstein D; Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, California, 90095, USA.
  • Fried I; Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, California, 90095, USA.
  • Wu C; Department of Neurology, Thomas Jefferson University, Philadelphia, Pennsylvania, 19107, USA.
  • Sharan A; Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, California, 90095, USA.
  • Engel J; Department of Neuroradiology, Thomas Jefferson University, Philadelphia, Pennsylvania, 19107, USA.
  • Staba R; Department of Neurosurgery, Thomas Jefferson University, Philadelphia, Pennsylvania, 19107, USA.
  • Sperling MR; Department of Neurosurgery, Thomas Jefferson University, Philadelphia, Pennsylvania, 19107, USA.
Epilepsia ; 64(5): e48-e55, 2023 05.
Article en En | MEDLINE | ID: mdl-36906958
How responsive neurostimulation (RNS) decreases seizure frequency is unclear. Stimulation may alter epileptic networks during inter-ictal epochs. Definitions of the epileptic network vary but fast ripples (FRs) may be an important substrate. We, therefore, examined whether stimulation of FR-generating networks differed in RNS super responders and intermediate responders. In 10 patients, with subsequent RNS placement, we detected FRs from stereo-electroencephalography (SEEG) contacts during pre-surgical evaluation. The normalized coordinates of the SEEG contacts were compared with those of the eight RNS contacts, and RNS-stimulated SEEG contacts were defined as those within 1.5 cm3 of the RNS contacts. We compared the post-RNS placement seizure outcome to (1) the ratio of stimulated SEEG contacts in the seizure-onset zone (SOZ stimulation ratio [SR]); (2) the ratio of FR events on stimulated contacts (FR SR); and (3) the global efficiency of the FR temporal correlational network on stimulated contacts (FR SGe). We found that the SOZ SR (p = .18) and FR SR (p = .06) did not differ in the RNS super responders and intermediate responders, but the FR SGe did (p = .02). In super responders, highly active desynchronous sites of the FR network were stimulated. RNS that better targets FR networks, as compared to the SOZ, may reduce epileptogenicity more.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Convulsiones / Electroencefalografía Límite: Humans Idioma: En Revista: Epilepsia Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
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Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Convulsiones / Electroencefalografía Límite: Humans Idioma: En Revista: Epilepsia Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos