Single Pulse Electrical Stimulation to identify epileptogenic cortex: Clinical information obtained from early evoked responses

B.E. Mouthaan, M.A. van 't Klooster, D. Keizer, G.J. Hebbink, F.S.S. Leijten, C.H. Ferrier, M.J.A.M. van Putten, M. Zijlmans, G.J.M. Huiskamp

Research output: Contribution to journalArticleAcademicpeer-review

25 Citations (Scopus)

Abstract

Objective: Single Pulse Electrical Stimulation (SPES) probes epileptogenic cortex during electrocorticography. Two SPES responses are described: pathological delayed responses (DR, >100 ms) associated with the seizure onset zone (SOZ) and physiological early responses (ER, <100 ms) that map cortical connectivity. We analyzed properties of ERs, including frequencies >80 Hz, in the SOZ and seizure propagation areas.

Methods: We used data from 12 refractory epilepsy patients. SPES consisted of 10 pulses of 1 ms, 4–8 mA and 5 s interval on adjacent electrodes pairs. Data were available at 2048 samples/s for six and 512 samples/s (22 bits) for eight patients and analyzed in the time–frequency (TF) and time-domain (TD).

Results: Electrodes with ERs were stronger associated with SOZ than non-SOZ electrodes. ERs with frequency content >80 Hz exist and are specific for SOZ channels. ERs evoked by stimulation of seizure onset electrodes were associated with electrodes involved in seizure propagation.

Conclusion: Analysis of ERs can reveal aspects of pathology, manifested by association with seizure propagation and areas with high ER numbers that coincide with the SOZ.

Significance: Not only DRs, but also ERs could have clinical value for mapping epileptogenic cortex and help to unravel aspects of the epileptic network.

Original languageEnglish
Pages (from-to)1088-1098
Number of pages11
JournalClinical neurophysiology
Volume127
Issue number2
DOIs
Publication statusPublished - Feb 2016

Keywords

  • High frequency oscillations
  • Intracranial electrodes
  • evoked potentials
  • EWI-26948
  • Electrical stimulation
  • Epilepsy surgery

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    Mouthaan, B. E., van 't Klooster, M. A., Keizer, D., Hebbink, G. J., Leijten, F. S. S., Ferrier, C. H., ... Huiskamp, G. J. M. (2016). Single Pulse Electrical Stimulation to identify epileptogenic cortex: Clinical information obtained from early evoked responses. Clinical neurophysiology, 127(2), 1088-1098. https://doi.org/10.1016/j.clinph.2015.07.031