Stimulation Mapping Using Stereoelectroencephalography: Current and Future Directions

George, Derek D.; Ojemann, Steven G.; Drees, Cornelia; Thompson, John A.

doi:10.3389/fneur.2020.00320

Cited by 39 publications

(26 citation statements)

References 72 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The resulting individualized strategy of electrodes implantation not only allows delineating the epileptogenic network but also mapping eloquent cortex ( Li et al, 2020 ). There have been in the past decade a growing interest in sEEG because it allows accessing deep structures such as insula or hippocampus ( Salado et al, 2018 ) and has a lower complication rates than subdural grids ( Tandon et al, 2019 ; George et al, 2020 ).…”

Section: Methodological Aspects Of Electrical Cortical Stimulation Usmentioning

confidence: 99%

Language Mapping Using Stereo Electroencephalography: A Review and Expert Opinion

Aron

Jonas

Colnat-Coulbois

et al. 2021

Front. Hum. Neurosci.

View full text Add to dashboard Cite

Stereo-electroencephalography (sEEG) is a method that uses stereotactically implanted depth electrodes for extra-operative mapping of epileptogenic and functional networks. sEEG derived functional mapping is achieved using electrical cortical stimulations (ECS) that are currently the gold standard for delineating eloquent cortex. As this stands true especially for primary cortices (e.g., visual, sensitive, motor, etc.), ECS applied to higher order brain areas determine more subtle behavioral responses. While anterior and posterior language areas in the dorsal language stream seem to share characteristics with primary cortices, basal temporal language area (BTLA) in the ventral temporal cortex (VTC) behaves as a highly associative cortex. After a short introduction and considerations about methodological aspects of ECS using sEEG, we review the sEEG language mapping literature in this perspective. We first establish the validity of this technique to map indispensable language cortices in the dorsal language stream. Second, we highlight the contrast between the growing empirical ECS experience and the lack of understanding regarding the fundamental mechanisms underlying ECS behavioral effects, especially concerning the dispensable language cortex in the VTC. Evidences for considering network architecture as determinant for ECS behavioral response complexities are discussed. Further, we address the importance of designing new research in network organization of language as this could enhance ECS ability to map interindividual variability, pathology driven reorganization, and ultimately identify network resilience markers in order to better predict post-operative language deficit. Finally, based on a whole body of available studies, we believe there is strong evidence to consider sEEG as a valid, safe and reliable method for defining eloquent language cortices although there have been no proper comparisons between surgical resections with or without extra-operative or intra-operative language mapping.

show abstract

Section: Methodological Aspects Of Electrical Cortical Stimulation Usmentioning

confidence: 99%

Language Mapping Using Stereo Electroencephalography: A Review and Expert Opinion

Aron

Jonas

Colnat-Coulbois

et al. 2021

Front. Hum. Neurosci.

View full text Add to dashboard Cite

show abstract

“…In the univariate analyses, the majority of significant factors included those directly related to the seizures, such as the number of seizures recorded, whether or not a seizure was stimulated and whether this stimulated seizure was a habitual seizure (Supplementary Table 3) all of which underscore the importance selecting patients that have frequent habitual seizures and stimulating these during intracranial recording. 18…”

Section: Discussionmentioning

confidence: 99%

The UK experience of stereoelectroencephalography in children: An analysis of factors predicting the identification of a seizure onset zone and subsequent seizure freedom

Chari

Moeller²,

Boyd³

et al. 2021

Preprint

View full text Add to dashboard Cite

Importance: Stereoelectroencephalography (SEEG) is more frequently being used in the pre-surgical evaluation of children with focal epilepsy. Many factors affect the rate of identification of a definable seizure onset zone (SOZ) and subsequent seizure freedom following SEEG-guided epilepsy surgery, which have not been systematically examined in multi-centre studies. Objectives: Determine the rates and factors that predict (a) whether or not a definable putative SOZ was identified on SEEG and (b) subsequent seizure freedom following surgical intervention. Design: Retrospective cohort study Setting: Multicentre study involving 6 of 7 UK Childrens Epilepsy Surgery Service centres that perform paediatric SEEG in the UK. Participants: All children undergoing SEEG from 2014 - March 2019 were included. Demographic, non-invasive evaluation, SEEG and operative factors were collected retrospectively from patient records. Main Outcomes: The two main outcome measures were (a) whether or not a definable putative SOZ was identified on SEEG (binary yes/no outcome) and (b) subsequent seizure freedom following surgical intervention (Engel classification) Findings: One hundred and thirty-five patients underwent 139 SEEG explorations using a total of 1767 electrodes. A definable SOZ was identified in 117 patients (85.7%); odds of successfully finding a SOZ were 6.4x greater for non-motor seizures compared to motor seizures (p=0.02) and 3.6x more if >=4 seizures were recorded during SEEG (p=0.03). Of 100 patients undergoing surgical treatment, 47 (47.0%) had an Engel class I outcome at a median follow-up of 1.3 years; the only factor associated with outcome was indication for SEEG (p=0.03). SEEG was safe with one (0.7%) haematoma requiring surgical evacuation and no long-term neurological deficits as a result of the procedure. Conclusions and Relevance: This large nationally representative cohort illustrates that, in these patients who may not have otherwise been offered resective surgery, SEEG-guided surgery can still achieve high rates of seizure freedom. Seizure semiology and the number of seizures recorded during SEEG are important factors in the identification of a definable SOZ and the indication for SEEG is an important factor in post-operative outcomes.

show abstract

“…Eloquent cortices are avoided whenever possible although intentional insertion in these cortices can be performed if necessary (i.e., for delimiting the EZ from the eloquent areas). 21 , 32) Theoretically, the general prevalence of hemorrhagic complication in SEEG (around 1%) 33) applies to these areas but with serious risks of significant functional deficits.…”

Section: Technical Considerations During Seeg Electrode Placementmentioning

confidence: 99%

Technical Aspects of SEEG and Its Interpretation in the Delineation of the Epileptogenic Zone

Khoo

Hall

Dubeau

et al. 2020

Neurol. Med. Chir.(Tokyo)

View full text Add to dashboard Cite

Stereo-electroencephalography (SEEG) has gained global popularity in recent years. In Japan, a country in which invasive studies using subdural electrodes (SDEs) have been the mainstream, SEEG has been approved for insurance coverage in 2020 and is expected to gain in popularity. Some concepts supporting SEEG methodology are fundamentally different from that of SDE studies. Clinicians interested in utilizing SEEG in their practice should be aware of those aspects in which they differ. Success in utilizing the SEEG methodology relies heavily on the construction of an a priori hypothesis regarding the putative seizure onset zone (SOZ) and propagation. This article covers the technical and theoretical aspects of SEEG, including the surgical techniques and precautions, hypothesis construction, and the interpretation of the recording, all with the aim of providing an introductory guide to SEEG.

show abstract

Stimulation Mapping Using Stereoelectroencephalography: Current and Future Directions

Cited by 39 publications

References 72 publications

Language Mapping Using Stereo Electroencephalography: A Review and Expert Opinion

Language Mapping Using Stereo Electroencephalography: A Review and Expert Opinion

The UK experience of stereoelectroencephalography in children: An analysis of factors predicting the identification of a seizure onset zone and subsequent seizure freedom

Technical Aspects of SEEG and Its Interpretation in the Delineation of the Epileptogenic Zone

Contact Info

Product

Resources

About