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Specific afterdischarge properties can enhance the clinical utility of electrical stimulation mapping during intracranial monitoring.
Kons, Zachary A; Kokkinos, Vasileios; Hadanny, Amir; Muñoz, William; Sisterson, Nathaniel; Simon, Mirela; Urban, Alexandra; Richardson, R Mark.
Afiliación
  • Kons ZA; Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, USA; Virginia Commonwealth University School of Medicine, Richmond, VA, USA.
  • Kokkinos V; Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
  • Hadanny A; Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, USA.
  • Muñoz W; Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, USA.
  • Sisterson N; Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, USA.
  • Simon M; Harvard Medical School, Boston, MA, USA; Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
  • Urban A; Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA; University of Pittsburgh Comprehensive Epilepsy Center, Pittsburgh, PA, USA.
  • Richardson RM; Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA. Electronic address: mark.richardson@mgh.harvard.edu.
Clin Neurophysiol ; 159: 13-23, 2024 03.
Article en En | MEDLINE | ID: mdl-38241911
ABSTRACT

OBJECTIVE:

Extraoperative electrical cortical stimulation (ECS) facilitates defining the seizure onset zone (SOZ) and eloquent cortex. The clinical relevance of stimulation-induced afterdischarges (ADs) is not well defined.

METHODS:

Fifty-five patients who underwent intracranial electroencephalogram evaluations with ECS were retrospectively identified. ADs were identified in these recordings and categorized by pattern, location, and association with stimulation-induced seizures.

RESULTS:

ADs were generated in 1774/9285 (19%) trials. Rhythmic spikes and irregular ADs within the stimulated bipolar contact pair were predictive of location within the SOZ compared to non-epileptogenic/non-irritative cortex (rhythmic spikes OR 2.24, p = 0.0098; irregular OR 1.39; p = 0.013). ADs immediately preceding stimulated seizures occurred at lower stimulation intensity thresholds compared to other stimulations (mean 2.94 ± 0.28 mA vs. 4.16 ± 0.05 mA respectively; p = 0.0068).

CONCLUSIONS:

Changes in AD properties can provide clinically relevant data in extraoperative stimulation mapping.

SIGNIFICANCE:

Although not exclusive to the SOZ, the generation of rhythmic spikes may suggest that a stimulation location is within the SOZ, while decreased stimulation intensity thresholds eliciting ADs may alert clinicians to a heightened probability of seizure generation with subsequent stimulation.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Convulsiones / Electroencefalografía Límite: Humans Idioma: En Revista: Clin Neurophysiol Asunto de la revista: NEUROLOGIA / PSICOFISIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Convulsiones / Electroencefalografía Límite: Humans Idioma: En Revista: Clin Neurophysiol Asunto de la revista: NEUROLOGIA / PSICOFISIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Países Bajos