Considerations in performing and analyzing the responses of cortico‐cortical evoked potentials in stereo‐<scp>EEG</scp>

Prime, David J.; O'Keefe, S.G.; Dionisio, Sasha

doi:10.1111/epi.13939

Cited by 50 publications

(47 citation statements)

References 74 publications

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“…The stimulation is a biphasic charge‐balanced stimulation waveform. Given the contact surface and volume (Dixi or Alcis electrodes, approximately 0.05 cm²), the charge density was between 9 and 18 μC/cm², which is in the safety range (see Appendix S1) …”

Section: Methodsmentioning

confidence: 99%

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The effect of medial pulvinar stimulation on temporal lobe seizures

et al. 2019

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Summary We investigated the effect of electrical stimulation of the medial pulvinar (PuM) in terms of its effect on temporal lobe seizures. Eight patients with drug‐resistant temporal lobe epilepsy undergoing stereoelectroencephalographic exploration were included. All had at least one electrode exploring the PuM. High‐frequency (50 Hz) stimulations of the PuM were well tolerated in the majority of them. During diagnostic stimulation to confirm the epileptogenic zone, 19 seizures were triggered by stimulating the hippocampus. During some of these seizures, ipsilateral pulvinar stimulation was applied (130 Hz, pulse width = 450 microseconds, duration = 3‐7 seconds, 1‐2 mA). Compared to non–PuM‐stimulated seizures, five of eight patients experienced clinically less severe seizures, particularly in terms of degree of alteration of consciousness. On the electrical level, seizures were more rapidly clonic with a shorter tonic phase. This proof of concept study is the first to suggest that PuM stimulation could be a well‐tolerated and effective means of therapeutic deep brain stimulation in drug‐resistant epilepsies.

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Section: Methodsmentioning

confidence: 99%

“…Given the contact surface and volume (Dixi or Alcis electrodes, approximately 0.05 cm²), the charge density was between 9 and 18 μC/ cm², which is in the safety range (see Appendix S1). 13,14 We will refer of this type of seizure as a pulvinar-stimulated (Puv[+]) seizure.…”

Section: Effect Of Pum Stimulation On Seizures Induced By Hippocampmentioning

confidence: 99%

The effect of medial pulvinar stimulation on temporal lobe seizures

et al. 2019

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“…The lack of standardized stimulation parameters limits interpretation of the data, reducing its clinical utility [5,13,14]. The amplitude of stimulation may be 0.5 mA to >10 mA [6,9], which changes the charge density per phase that the tissue experiences [15].…”

Section: Introductionmentioning

confidence: 99%

A systematic exploration of parameters affecting evoked intracranial potentials in patients with epilepsy

et al. 2020

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Background: Brain activity is constrained by and evolves over a network of structural and functional connections. Corticocortical evoked potentials (CCEPs) have been used to measure this connectivity and to discern brain areas involved in both brain function and disease. However, how varying stimulation parameters influences the measured CCEP across brain areas has not been well characterized. Objective: To better understand the factors that influence the amplitude of the CCEPs as well as evoked gamma-band power (70e150 Hz) resulting from single-pulse stimulation via cortical surface and depth electrodes. Methods: CCEPs from 4370 stimulation-response channel pairs were recorded across a range of stimulation parameters and brain regions in 11 patients undergoing long-term monitoring for epilepsy. A generalized mixed-effects model was used to model cortical response amplitudes from 5 to 100 ms poststimulation. Results: Stimulation levels <5.5 mA generated variable CCEPs with low amplitude and reduced spatial spread. Stimulation at !5.5 mA yielded a reliable and maximal CCEP across stimulation-response pairs over all regions. These findings were similar when examining the evoked gamma-band power. The amplitude of both measures was inversely correlated with distance. CCEPs and evoked gamma power were largest when measured in the hippocampus compared with other areas. Larger CCEP size and evoked gamma power were measured within the seizure onset zone compared with outside this zone. Conclusion: These results will help guide future stimulation protocols directed at quantifying network connectivity across cognitive and disease states.

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“…Some studies found that there were different occurrence rates and CCEP amplitudes in patients with generalized epilepsy and those with focal epilepsy (33). We did not on studying this difference, because there were multiple seizure types in patients with TSC, and most of the patients suffered generalized seizure and focal seizure at the same time.…”

Section: Discussionmentioning

confidence: 99%

Cortico-Cortical Evoked Potentials in Children With Tuberous Sclerosis Complex Using Stereo-Electroencephalography

Ding

Liu

et al. 2019

Front. Neurol.

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Objectives: Patients with tuberous sclerosis complex (TSC) present multiple cortical tubers in the brain, which are responsible for epilepsy. It is still difficult to localize the epileptogenic tuber. The value of cortico-cortical evoked potentials (CCEPs) was assessed in epileptogenic tuber localization in patients with TSC using stereo-electroencephalography (SEEG).Methods: Patients with TSC who underwent SEEG and CCEP examination in preoperative evaluation during 2014–2017 and reached postoperative seizure freedom at 1-year follow-up were enrolled in this study (n = 11). CCEPs were conducted by stimulating every two adjacent contacts of SEEG electrodes and recording on other contacts of SEEG electrodes in one epileptogenic tuber and its early-stage propagating tuber, and their perituberal cortexes in each patient. The CCEP was defined as positive when N1 and/or N2 wave presented, and then the occurrence rates of positive CCEPs were then compared among different tubers and perituberal regions.Results: Occurrence rates of positive CCEP from epileptogenic tubers to early propagating tubers and epileptogenic tubers to perituberal cortexes were 100%, which were significantly higher than the occurrence rates of CCEP between other locations. The occurrence rates of CCEP from peripheral portions of epileptogenic tubers to peripheral portions of early propagating tubers or perituberal cortexes were 100%, which were significant higher than the occurrence rates of CCEP from peripheral regions of early propagating tubers to peripheral portions of epileptogenic tubers, from the central part of early propagating tuber to central portions of epileptogenic tubers, or from perituberal cortexes to the center part of epileptogenic tubers.Conclusion: Epileptogenic tubers presented much more diffusive connectivity with other tubers and perituberal cortexes than any other connectivity relationships across propagating tubers, and the peripheral region of epileptogenic tubers presented the greatest connectivity with propagating tubers and perituberal cortexes. CCEP can be an effective tool in epileptogenic tuber localization in patients with TSC.

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

Cited by 50 publications

References 74 publications

The effect of medial pulvinar stimulation on temporal lobe seizures

The effect of medial pulvinar stimulation on temporal lobe seizures

A systematic exploration of parameters affecting evoked intracranial potentials in patients with epilepsy

Cortico-Cortical Evoked Potentials in Children With Tuberous Sclerosis Complex Using Stereo-Electroencephalography

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