Properties of after-discharges from cortical electrical stimulation in focal epilepsies

Blume, Warren T.; Jones, Daniel; Pathak, Parbeen

doi:10.1016/j.clinph.2003.11.023

Cited by 126 publications

(93 citation statements)

References 21 publications

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“…The occurrence of afterdischarges in response to HC stimulation was expected based upon the extensive description of this phenomenon in the literature [33,34]. Some of these discharges had the characteristics of classically described ADs as shown in figure 6, while others appeared to be driven only during the stimulation burst.…”

Section: Discussionmentioning

confidence: 99%

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

Stypulkowski¹,

Stanslaski²,

Denison³

et al. 2013

Stereotact Funct Neurosurg

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Background/Aims: In conjunction with therapeutic stimulation, next-generation deep brain stimulation (DBS) devices may offer the ability to record and analyze neural signals, providing for unprecedented insight into DBS effects on neural networks. This work was conducted to evaluate an implantable, clinical-grade system that permits concurrent stimulation and recording using a large animal (ovine) model recently developed to study DBS for epilepsy. Methods: Following anesthesia and 1.5-tesla MRI acquisition, unilateral anterior thalamic and hippocampal DBS leads were implanted (n = 3) using a frameless stereotactic system. Chronic, awake recordings of evoked potentials (EPs) and local field potentials were collected with the implanted device and analyzed off-line. Results: Hippocampal EPs were stable over long-term (>1 year) recording and consistent in morphology and latency with prior acute results. Thalamic and hippocampal DBS produced both excitatory and inhibitory network effects that were stimulation site and parameter dependent. Free roaming recordings illustrated periods of highly correlated activity between these two structures within the circuit of Papez. Conclusions: These results provide further insight into mechanisms of DBS therapy for epilepsy and an encouraging demonstration of the capabilities of this new technology, which in the future, may afford unique opportunities to study human brain function and neuromodulation mechanism of action.

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Section: Discussionmentioning

confidence: 99%

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

Stypulkowski¹,

Stanslaski²,

Denison³

et al. 2013

Stereotact Funct Neurosurg

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“…This was an open issue in previous studies investigating primary generalized epilepsy and absence seizures in particular. Even in focal epilepsies, many studies have investigated the mechanisms of electrically induced afterdischarges or seizures, but the relationship of these events with respect to spontaneous seizures is still obscure (Bernier et al 1990;Blume et al 2004;Kalamangalam et al 2014;Wieser et al 1979). …”

Section: Network-mediated Entrainment Of the Epileptogenic Focus Leadmentioning

confidence: 99%

Spatiotemporal dynamics of optogenetically induced and spontaneous seizure transitions in primary generalized epilepsy

Wagner

Truccolo

Wang

et al. 2015

Journal of Neurophysiology

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Wagner FB, Truccolo W, Wang J, Nurmikko AV. Spatiotemporal dynamics of optogenetically induced and spontaneous seizure transitions in primary generalized epilepsy. J Neurophysiol 113: 2321-2341, 2015. First published December 31, 2014 doi:10.1152/jn.01040.2014.-Transitions into primary generalized epileptic seizures occur abruptly and synchronously across the brain. Their potential triggers remain unknown. We used optogenetics to causally test the hypothesis that rhythmic population bursting of excitatory neurons in a local neocortical region can rapidly trigger absence seizures. Most previous studies have been purely correlational, and it remains unclear whether epileptiform events induced by rhythmic stimulation (e.g., sensory/ electrical) mimic actual spontaneous seizures, especially regarding their spatiotemporal dynamics. In this study, we used a novel combination of intracortical optogenetic stimulation and microelectrode array recordings in freely moving WAG/Rij rats, a model of absence epilepsy with a cortical focus in the somatosensory cortex (SI). We report three main findings: 1) Brief rhythmic bursting, evoked by optical stimulation of neocortical excitatory neurons at frequencies around 10 Hz, induced seizures consisting of self-sustained spikewave discharges (SWDs) for about 10% of stimulation trials. The probability of inducing seizures was frequency-dependent, reaching a maximum at 10 Hz. 2) Local field potential power before stimulation and response amplitudes during stimulation both predicted seizure induction, demonstrating a modulatory effect of brain states and neural excitation levels. 3) Evoked responses during stimulation propagated as cortical waves, likely reaching the cortical focus, which in turn generated self-sustained SWDs after stimulation was terminated. Importantly, SWDs during induced and spontaneous seizures propagated with the same spatiotemporal dynamics. Our findings demonstrate that local rhythmic bursting of excitatory neurons in neocortex at particular frequencies, under susceptible ongoing brain states, is sufficient to trigger primary generalized seizures with stereotypical spatiotemporal dynamics.

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“…3 The current gold standard, electrocortical stimulation mapping (ESM), is time-consuming 4,5 and often induces afterdischarges or seizures. 4,6,7 Additionally, it is difficult to rule out distant effects through diaschisis or action potentials evoked by stimulation.7-9 These limitations have long motivated the investigation of passive electrocorticographic (ECoG) recordings as a tool for rapidly and safely mapping cortical function prior to resective surgery. …”

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confidence: 99%

Spatial-temporal functional mapping of language at the bedside with electrocorticography

et al. 2016

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Objective: To investigate the feasibility and clinical utility of using passive electrocorticography (ECoG) for online spatial-temporal functional mapping (STFM) of language cortex in patients being monitored for epilepsy surgery.Methods: We developed and tested an online system that exploits ECoG's temporal resolution to display the evolution of statistically significant high gamma (70-110 Hz) responses across all recording sites activated by a discrete cognitive task. We illustrate how this spatial-temporal evolution can be used to study the function of individual recording sites engaged during different language tasks, and how this approach can be particularly useful for mapping eloquent cortex.Results: Using electrocortical stimulation mapping (ESM) as the clinical gold standard for localizing language cortex, the average sensitivity and specificity of online STFM across 7 patients were 69.9% and 83.5%, respectively. Moreover, relative to regions of interest where discrete cortical lesions have most reliably caused language impairments in the literature, the sensitivity of STFM was significantly greater than that of ESM, while its specificity was also greater than that of ESM, though not significantly so. Functional human brain mapping is commonly performed during or prior to invasive brain surgery for the treatment of drug-refractory epilepsy 1,2 and brain tumors. 3 The current gold standard, electrocortical stimulation mapping (ESM), is time-consuming 4,5 and often induces afterdischarges or seizures. 4,6,7 Additionally, it is difficult to rule out distant effects through diaschisis or action potentials evoked by stimulation.7-9 These limitations have long motivated the investigation of passive electrocorticographic (ECoG) recordings as a tool for rapidly and safely mapping cortical function prior to resective surgery. 10-12Here we introduce and test the feasibility and clinical utility of an online trial-based system for spatial-temporal functional mapping (STFM) of language cortex. High-gamma (HG, ; power changes have been demonstrated to be a robust and reliable index of task-related activation of cortical populations of neurons with high spatial and temporal specificity.13,14 The STFM system builds upon previous passive ECoG mapping software [15][16][17][18] by providing a trialbased framework for online display and statistical validation of HG dynamics.In 7 patients, estimates of the system's sensitivity and specificity for language mapping, relative to the benchmark of ESM, were the same or better than previous reports.18-21 Moreover, we found that relative to predefined language cortex boundaries, the sensitivity and specificity of *These authors contributed equally to this work.

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Properties of after-discharges from cortical electrical stimulation in focal epilepsies

Cited by 126 publications

References 21 publications

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

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

Spatiotemporal dynamics of optogenetically induced and spontaneous seizure transitions in primary generalized epilepsy

Spatial-temporal functional mapping of language at the bedside with electrocorticography

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