Electrical stimulation sensorimotor mapping with stereo-EEG. Issue 8 (August 2020)

• Record Type: Journal Article
• Authors: Arya, Ravindra; Ervin, Brian; Holloway, Timothy; Dudley, Jonathan; Horn, Paul S.; Buroker, Jason; Rozhkov, Leonid; Scholle, Craig; Byars, Anna W.; Leach, James L.; Mangano, Francesco T.; Greiner, Hansel M.; Holland, Katherine D.
• Is Part Of: Clinical neurophysiology. Volume 131:Issue 8(2020:Aug.)
• Page Start: 1691
• Page End: 1701
• Publication Date: 2020-08
• Subjects: Intracranial electrodes -- Epilepsy surgery -- Cortical localization -- Functional brain mapping; Neurophysiology -- Periodicals; Electroencephalography -- Periodicals; Electromyography -- Periodicals; Neurology -- Periodicals; 612.8
• DOI: 10.1016/j.clinph.2020.04.159
• Languages: English
• ISSNs: 1388-2457

Abstract

Highlights: Stereo-EEG sensorimotor mapping was prospectively compared with reference neuroanatomy. Electrical stimulation mapping localized anatomic sensorimotor parcels with high accuracy. Sensorimotor thresholds below after-discharge thresholds suggest safety of stereo-EEG ESM. Abstract: Objective: We evaluated stereo-EEG electrical stimulation mapping (ESM) for localization of anatomic sensorimotor parcels in pediatric patients with drug-resistant epilepsy. We also analyzed sensorimotor and after-discharge thresholds, and the somatotopy of sensorimotor responses. Methods: ESM was performed with 50 Hz, biphasic, 2–3 s trains, using 1–9 mA current. Pre- and post-implant neuroimaging was co-registered and intersected with Neurosynth reference, to classify each electrode contact as lying within/outside an anatomic sensorimotor parcel. Indices of diagnostic performance were computed. Sensorimotor and after-discharge thresholds were analyzed using multivariable linear mixed models. Results: In 15 patients (6 females), aged 5.5–21.2 years, ESM showed high accuracy (0.80), high specificity (0.86), and diagnostic odds ratio (11.4, p < 0.0001) for localization of sensorimotor parcels. Mean sensorimotor threshold (3.4 mA) was below mean after-discharge threshold (4.2 mA, p = 0.0004). Sensorimotor and after-discharge thresholds showed a significant decrease with increasing intelligence quotient. Somatotopy of sensorimotor responses was mapped to standardized brain parcels. Conclusions: We provide evidence for diagnostic validity and safety of stereo-EEG sensorimotor ESM. Significance: The somatotopy of sensorimotor responses elicited with electrical stimulation provide new insights into mechanisms of motor control and sensory perception.