A comparative study of the effects of pulse parameters for intracranial direct electrical stimulation in epilepsy

Donos, Cristian; Mı̂ndruță, Ioana; Ciurea, Jean; Mălîia, Mihai Dragoş; Barborică, Andrei

doi:10.1016/j.clinph.2015.02.013

Cited by 53 publications

(61 citation statements)

References 59 publications

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“…Our model is able to reproduce common properties of ERs, like the linear relation between stimulation strength and the amplitude of ERs (Donos, Mîndrută, Ciurea, Mălîia, & Barborica, ). It has been reported that the majority of the waveforms contains either a N1 or a N2 component, or both (Alarcón et al., ).…”

Section: Discussionmentioning

confidence: 92%

Pathological responses to single‐pulse electrical stimuli in epilepsy: The role of feedforward inhibition

Hebbink

Huiskamp

Gils

et al. 2019

Eur J of Neuroscience

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Delineation of epileptogenic cortex in focal epilepsy patients may profit from single‐pulse electrical stimulation during intracranial EEG recordings. Single‐pulse electrical stimulation evokes early and delayed responses. Early responses represent connectivity. Delayed responses are a biomarker for epileptogenic cortex, but up till now, the precise mechanism generating delayed responses remains elusive. We used a data‐driven modelling approach to study early and delayed responses. We hypothesized that delayed responses represent indirect responses triggered by early response activity and investigated this for 11 patients. Using two coupled neural masses, we modelled early and delayed responses by combining simulations and bifurcation analysis. An important feature of the model is the inclusion of feedforward inhibitory connections. The waveform of early responses can be explained by feedforward inhibition. Delayed responses can be viewed as second‐order responses in the early response network which appear when input to a neural mass falls below a threshold forcing it temporarily to a spiking state. The combination of the threshold with noisy background input explains the typical stochastic appearance of delayed responses. The intrinsic excitability of a neural mass and the strength of its input influence the probability at which delayed responses to occur. Our work gives a theoretical basis for the use of delayed responses as a biomarker for the epileptogenic zone, confirming earlier clinical observations. The combination of early responses revealing effective connectivity, and delayed responses showing intrinsic excitability, makes single‐pulse electrical stimulation an interesting tool to obtain data for computational models of epilepsy surgery.

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Section: Discussionmentioning

confidence: 92%

Pathological responses to single‐pulse electrical stimuli in epilepsy: The role of feedforward inhibition

Hebbink

Huiskamp

Gils

et al. 2019

Eur J of Neuroscience

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“…Multiple stimulation protocols were carried out routinely as part of the standard presurgical assessment (Trebuchon & Chauvel, ) using low frequency 1 Hz (Munari et al, ) and single‐pulse electrical stimulation (Donos, Mîndruţă, Ciurea, Mălîia, & Barborica, ; Matsumoto, Kunieda, & Nair, ), as well as high frequency 50 Hz (HFS; Bernier et al, ) direct electrical stimulation; however, only HFS was able to elicit clinical effects of changes in body perception. Therefore, functional mapping of the cortex was systematically reviewed using direct electrical high frequency stimulation of the brain delivered at a rate of 50 Hz (Figure c).…”

Section: Methodsmentioning

confidence: 99%

“…Therefore, functional mapping of the cortex was systematically reviewed using direct electrical high frequency stimulation of the brain delivered at a rate of 50 Hz (Figure c). Bipolar stimulations were performed through pairs of adjacent contacts using a programmable clinical stimulator (Guideline4000LP+, FHC, Bowdoin, ME) in Bucharest and Osirix Cortical Stimulator (Emmendingen, Germany) in Strasbourg with a square, biphasic, 1 ms width pulse for 5 s. In addition, in a subset of patients, resting‐state connectivity was calculated based on cortico‐cortical evoked potentials elicited by single‐pulse electrical stimulation (Supporting Information S1) using the methodology presented in detail in Donos et al () and Donos, Mîndruţă et al ().…”

Section: Methodsmentioning

confidence: 99%

Illusory own body perceptions mapped in the cingulate cortex—An intracranial stimulation study

Popa

Barborică

Scholly

et al. 2019

Human Brain Mapping

Self Cite

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Body awareness is the result of sensory integration in the posterior parietal cortex; however, other brain structures are part of this process. Our goal is to determine how the cingulate cortex is involved in the representation of our body. We retrospectively selected patients with drug‐resistant epilepsy, explored by stereo‐electroencephalography, that had the cingulate cortex sampled outside the epileptogenic zone. The clinical effects of high‐frequency electrical stimulation were reviewed and only those sites that elicited changes related to body perception were included. Connectivity of the cingulate cortex and other cortical structures was assessed using the h2 coefficient, following a nonlinear regression analysis of the broadband EEG signal. Poststimulation changes in connectivity were compared between two sets of stimulations eliciting or not eliciting symptoms related to body awareness (interest and control groups). We included 17 stimulations from 12 patients that reported different types of body perception changes such as sensation of being pushed toward right/left/up, one limb becoming heavier/lighter, illusory sensation of movement, sensation of pressure, sensation of floating or detachment of one hemi‐body. High‐frequency stimulation in the cingulate cortex (1 anterior, 15 middle, 1 posterior part) elicits body perception changes, associated with a decreased connectivity of the dominant posterior insula and increased coupling between other structures, located particularly in the nondominant hemisphere.

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“…Cortico‐cortical evoked potentials (CCEPs) utilize low‐frequency (<2 Hz) electrical stimulation to highlight electrical connectivity between brain regions. A variant of CCEPs known as single‐pulse electrical stimulation (SPES), which uses even lower frequencies (<0.25 Hz), has been reported for the same purpose . CCEP studies have been used to map key functional networks such as the human language network, limbic system and motor systems .…”

Section: Introductionmentioning

confidence: 99%

Considerations in performing and analyzing the responses of cortico‐cortical evoked potentials in stereo‐EEG

2017

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SummaryThis review aims to highlight key considerations when performing cortico-cortical evoked potentials (CCEPs) using stereo-electroencephalography (SEEG) for network mapping and show its clinical applicability to presurgical evaluations. The parameters for performing stimulation and safety aspects have been investigated in electrocorticography (ECoG) and deep brain stimulation (DBS), but not as extensively in SEEG. A review of current literature was performed, with an attempt made to emphasize practical insights from all modalities of intracranial stimulation. This paper reviews physical stimulation parameters, highlights safety limits, and considers the influence of changing common stimulation parameters.These factors are put into the context of CCEPs in SEEG. Given the paucity of direct research in this area, studies utilizing low frequency stimulation, DBS, and ECoG are incorporated along with the fundamental principles of electrical engineering. In addition, postprocessing considerations are reviewed, including electrode localization, application of digital filters, baseline selection, application of connectivity metrics, and higher order network analysis. The aim is to guide CCEP stimulation as well as to provide an understanding of the underlying principles of this technique. At present, there are few articles detailing the design of low-frequency stimulation paradigms, especially in the setting of SEEG. Providing a review of the fundamentals and postprocessing considerations when performing CCEPs in SEEG will increase the accessibility of this technique. K E Y W O R D Sbrain mapping, CCEP, connectivity, electrical stimulation, review, SEEG

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A comparative study of the effects of pulse parameters for intracranial direct electrical stimulation in epilepsy

Cited by 53 publications

References 59 publications

Pathological responses to single‐pulse electrical stimuli in epilepsy: The role of feedforward inhibition

Pathological responses to single‐pulse electrical stimuli in epilepsy: The role of feedforward inhibition

Illusory own body perceptions mapped in the cingulate cortex—An intracranial stimulation study

Considerations in performing and analyzing the responses of cortico‐cortical evoked potentials in stereo‐EEG

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