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

28 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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