Threshold and distribution of afterdischarges with electrical cortical stimulation. (September 2018)

• Record Type: Journal Article
• Authors: Suzuki, Hime; Enatsu, Rei; Kanno, Aya; Suzuki, Yuto; Yokoyama, Rintaro; Ookawa, Satoshi; Ochi, Satoko; Mikuni, Nobuhiro
• Is Part Of: Journal of clinical neuroscience. Volume 55(2018)
• Page Start: 71
• Page End: 75
• Publication Date: 2018-09
• Subjects: Afterdischarge -- Electric cortical stimulation -- Functional brain mapping -- Epilepsy -- Intracranial electrode; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2018.06.039
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: The present study investigated the threshold and distribution of afterdischarges (ADs). The thresholds of ADs induction were not affected by lobar differences and epileptogenicity. The stimulation of premotor areas appeared to induce ADs in remote cortices. Abstract: Objective: The present study aimed to investigate the threshold and distribution of afterdischarges (ADs) with cortical electrical stimulation for functional brain mapping. Method: We retrospectively analyzed data from 11 patients with medically intractable epilepsy who underwent 50-Hz cortical electrical stimulation for functional mapping followed by resection. These patients became seizure free for more than six months. The threshold and distribution of ADs induced by the stimulation were evaluated. Results: The median threshold was 6 mA (range: 2–15 mA) for the frontal lobe, 8 mA (3–15 mA) for the temporal lobe, 6 mA (2–15 mA) for the parietal lobe, and 6 mA (4–12 mA) for the occipital lobe. No significant interlobar differences were observed in AD thresholds. No significant differences were noted between within and outside epileptogenic zones. The distribution of ADs, remote spread was observed in all patients, reflecting fronto-parieto-temporal connections, as well as contiguous spread. The stimulation of premotor areas, the inferior parietal lobule, supplementary motor area, and basal temporal areas appeared to induce ADs in remote cortices. Conclusion: While no locational differences were observed in AD thresholds, each brain region showed a characteristic pattern for AD spread. Remote AD spread needs to be considered for safe functional mapping.