Afterdischarges elicited by cortical electric stimulation in humans: When do they occur and what do they mean?

Gollwitzer, Stephanie; Hopfengärtner, R.; Rössler, Karl; Müller, T; Olmes, David G.; Lang, Johannes; Köhn, J.; Onugoren, Müjgan Dogan; Heyne, Jana; Schwab, Stefan; Hamer, Hajo M.

doi:10.1016/j.yebeh.2018.09.007

Cited by 19 publications

(24 citation statements)

References 31 publications

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“…Importantly, 65% of AD's involved more than just stimulated electrodes. In another study of 20 adults, 14% of stimulations were associated with AD's including even those outside the irritative zone (Gollwitzer et al, 2018). In the large pediatric study referred to above, AD's were seen in 77% of patients (Aungaroon et al, 2017).…”

Section: After-dischargesmentioning

confidence: 88%

Electrical Stimulation Mapping of Brain Function: A Comparison of Subdural Electrodes and Stereo-EEG

Grande

Ihnen

Arya

2020

Front. Hum. Neurosci.

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Despite technological and interpretative advances, the non-invasive modalities used for pre-surgical evaluation of patients with drug-resistant epilepsy (DRE), fail to generate a concordant anatomo-electroclinical hypothesis for the location of the seizure onset zone in many patients. This requires chronic monitoring with intracranial electroencephalography (EEG), which facilitates better localization of the seizure onset zone, and allows evaluation of the functional significance of cortical regions-of-interest by electrical stimulation mapping (ESM). There are two principal modalities for intracranial EEG, namely subdural electrodes and stereotactic depth electrodes (stereo-EEG). Although ESM is considered the gold standard for functional mapping with subdural electrodes, there have been concerns about its utility with stereo-EEG. This is mainly because subdural electrodes allow contiguous sampling of the dorsolateral convexity of cerebral hemispheres, and permit delineation of the extent of eloquent functional areas on the cortical surface. Stereo-EEG, while having relatively sparse sampling on the cortical surface, offers the ability to access the depth of sulci, mesial and basal surfaces of cerebral hemispheres, and deep structures such as the insula, which are largely inaccessible to subdural electrodes. As stereo-EEG is increasingly the preferred modality for intracranial monitoring, we find it opportune to summarize the literature for ESM with stereo-EEG in this narrative review. Emerging evidence shows that ESM for defining functional neuroanatomy is feasible with stereo-EEG, but probably requires a different approach for interpretation and clinical decision making compared to ESM with subdural electrodes. We have also compared ESM with stereo-EEG and subdural electrodes, for current thresholds required to evoke desired functional responses vs. unwanted after-discharges. In this regard, there is preliminary evidence that ESM with stereo-EEG may be safer than ESM with subdural grids. Finally, we have highlighted important unanswered clinical and scientific questions for ESM with stereo-EEG in the hope to encourage future research and collaborative efforts.

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Section: After-dischargesmentioning

confidence: 88%

Electrical Stimulation Mapping of Brain Function: A Comparison of Subdural Electrodes and Stereo-EEG

Grande

Ihnen

Arya

2020

Front. Hum. Neurosci.

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“…Both approaches are able to determine the functional sites and the absence of the response is not dependent of which method we use but on knowing the advantages and disadvantages of both of them. In general, if the current intensity is used in order to prevent the appearance of afterdischarge potentials and the threshold is less than the minimum necessary to identify the functional sites, then false negative response will be generated [12,14].…”

Section: Discussionmentioning

confidence: 99%

The impact and causes of negative cortical mapping in primary motor area tumours

Coșman¹,

Iliescu²,

Sava³

et al. 2021

roneuro

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Introduction: Intraoperative neurophysiological monitoring is the golden standard for lesions located in eloquent areas of the brain. On the one hand, positive mapping offers a view of the relationship between the anatomo-functional cortical organisation of the patient and the lesion, facilitating the choice of the cerebrotomy entry point and the resection until the functional borders are found. On the other hand, negative mapping does not offer certainty that the absence of the motor response, from the operative field, is the real feedback or is the result of the false-negative response. In such a situation, a differentiation between those two must be done. Materials and methods: We evaluated the results of direct cortical stimulation of lesion located in or near the primary motor area, which were diagnosticated with contrast-enhancement head MRI and admitted to the Third Department of Neurosurgery, "Prof. Dr N. Oblu” Emergency Clinical Hospital, Iasi, Romania, between January 2014 and July 2018. Special attention was given especially to the negative mapping cases, regarding the histological type, imagistic localisation, symptoms and neurological outcome immediate postoperative, at 6 months and one-year follow-up. Results: From all 66 patients meeting the inclusion and exclusion criteria in 9,09% (6 cases) we did not obtain any motor response after direct cortical stimulation. The imagistic localisations of those cases were: 3 – Rolandic, 2 – pre-Rolandic and one retro-Rolandic. Tumors histological types were: glioblastoma, anaplastic astrocytoma, oligoastrocytoma and oligodendroglioma each one case and two cases of fibrillary astrocytoma. The intensity range was between 6 – 18mA, the mode – 12mA and the median – 10mA. Postoperatively the neurological condition of 3 patients worsened (4,54% from all the cases), while 3 had a favourable evolution with symptom remission. At 6monts and one-year follow-up in one case (1,51%), we observed no improvement in contrast with the other two, where dysfunction remission was highlighted. Conclusion: The possible technical, surgical and anesthesiologic causes of false-negative motor response must be eliminated to be able to differentiate from the real absence of the functional area from the operative field. In the first scenario, the resection may be associated with permanent postoperative neurologic deficit and major life quality alteration while in the second one the patient presents no motor dysfunction after surgery and the resection may be extensive with multiple oncological benefits.

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“…In correlation to humans, a consistent finding across multiple studies is that the highest incidence of SE is among children under 1 year of age [ 37 , 38 ]. One human year almost is equal to approximately two rat weeks (13.8 days) when correlating their entire life span [ 39 ].…”

Section: Introductionmentioning

confidence: 99%

Adenosine Kinase Isoforms in the Developing Rat Hippocampus after LiCl/Pilocarpine Status Epilepticus

Fabera

Uttl

Kubová

et al. 2022

IJMS

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LiCl/pilocarpine status epilepticus (SE) induced in immature rats leads, after a latent period, to hippocampal hyperexcitability. The excitability may be influenced by adenosine, which exhibits anticonvulsant activity. The concentration of adenosine is regulated by adenosine kinase (ADK) present in two isoforms—ADK-L and ADK-S. The main goal of the study is to elucidate the changes in ADK isoform expression after LiCl/pilocarpine SE and whether potential changes, as well as inhibition of ADK by 5-iodotubercidin (5-ITU), may contribute to changes in hippocampal excitability during brain development. LiCl/pilocarpine SE was elicited in 12-day-old rats. Hippocampal excitability in immature rats was studied by the model of hippocampal afterdischarges (ADs), in which we demonstrated the potential inhibitory effect of 5-ITU. ADs demonstrated significantly decreased hippocampal excitability 3 days after SE induction, whereas significant hyperexcitability after 20 days compared to controls was shown. 5-ITU administration showed its inhibitory effect on the ADs in 32-day-old SE rats compared to SE rats without 5-ITU. Moreover, both ADK isoforms were examined in the immature rat hippocampus. The ADK-L isoform demonstrated significantly decreased expression in 12-day-old SE rats compared to the appropriate naïve rats, whereas increased ADK-S isoform expression was revealed. A decreasing ADK-L/-S ratio showed the declining dominance of ADK-L isoform during early brain development. LiCl/pilocarpine SE increased the excitability of the hippocampus 20 days after SE induction. The ADK inhibitor 5-ITU exhibited anticonvulsant activity at the same age. Age-related differences in hippocampal excitability after SE might correspond to the development of ADK isoform levels in the hippocampus.

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Afterdischarges elicited by cortical electric stimulation in humans: When do they occur and what do they mean?

Cited by 19 publications

References 31 publications

Electrical Stimulation Mapping of Brain Function: A Comparison of Subdural Electrodes and Stereo-EEG

Electrical Stimulation Mapping of Brain Function: A Comparison of Subdural Electrodes and Stereo-EEG

The impact and causes of negative cortical mapping in primary motor area tumours

Adenosine Kinase Isoforms in the Developing Rat Hippocampus after LiCl/Pilocarpine Status Epilepticus

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