Intraoperative neurophysiological responses in epileptic patients submitted to hippocampal and thalamic deep brain stimulation

Abstract

Macrostimulation might be used to confirm that the hardware was working properly. There was no typical RR derived from each studied thalamic nuclei after LF stimulation. On the other hand, absence of such RRs was highly suggestive of hardware malfunction or inadequate targeting. Thalamic-DBS (Th-DBS) RR was always bilateral after unilateral stimulation, although they somehow prevailed over the stimulated hemisphere. Contrary to Th-DBS, Hip-DBS gave rise to localized RR over the ipsolateral temporal neocortex, and absence of this response might very likely be related to inadequate targeting or hardware failure. Increased spiking was seen over temporal neocortex during hippocampal electrode insertion; this might point to the more epileptogenic hippocampal region in each individual patient. We did not notice any intraoperative response difference among patients with temporal lobe epilepsy with or without MTS. The relationship between these intraoperative findings and seizure outcome is not yet clear and should be further evaluated.

Chronic Evaluation of a Clinical System for Deep Brain Stimulation and Recording of Neural Network Activity

“…In addition, the demonstration of sustained HC inhibition produced by local stimulation at relatively low levels in the awake animal is intriguing, given studies of this DBS modality to treat temporal lobe epilepsy [35,36,37]. …”

Relationship between Postoperative EEG Driving Response and Lead Location in Deep Brain Stimulation of the Anterior Nucleus of the Thalamus for Refractory Epilepsy

“…A rhythmic scalp electroencephalographic (EEG) synchronizing driving response (DR) which was clearly observed during low-frequency stimulation of the ANT has been regarded as an indicator which signifies that the locus of the electrode contact is at least within the thalamic nuclei (ANT or mediodorsal nucleus, MD) [5,6,7,8,9]. Although the localizing value of DR within thalamic subnuclei was not verified, elicitation of DR after ANT DBS was suggested to have a role in the verification of the placement of the stimulating electrodes in thalamic tissue [6].…”

Deep Brain Stimulation for the Treatment of Epilepsy: Circuits, Targets, and Trials

“…Cukiert et al [68] recently reported suppression of interictal spiking with intraoperative test stimulation (130 Hz, 300 μs, 4 V) in 4/6 patients undergoing bilateral hippocampal DBS placement, but associated clinical outcomes have not yet been reported for this cohort.…”