Comparison of bipolar versus monopolar extraoperative electrical cortical stimulation mapping in patients with focal epilepsy

Kovač, Stjepana; Scott, Catherine; Maglajlija, Vesela; Toms, N.; Rodionov, Roman; Miserocchi, Anna; McEvoy, Andrew W.; Diehl, Beate

doi:10.1016/j.clinph.2013.09.026

Cited by 29 publications

(19 citation statements)

References 22 publications

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“…Following standard clinical practice, the patients were asked to perform self-paced, repetitive actions—vocally or manually in different blocks—while electrical current was briefly delivered between pairs of neighboring grid electrodes, one pair at a time, for manually controlled durations of a few seconds [17]. Each action consisted of alternating movements at a frequency the patient chose spontaneously but was asked to maintain at a constant value.…”

Section: Resultsmentioning

confidence: 99%

Reversed Procrastination by Focal Disruption of Medial Frontal Cortex

et al. 2016

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SummaryAn enduring puzzle in the neuroscience of voluntary action is the origin of the remarkably wide dispersion of the reaction time distribution, an interval far greater than is explained by synaptic or signal transductive noise [1, 2]. That we are able to change our planned actions—a key criterion of volition [3]—so close to the time of their onset implies decision-making must reach deep into the execution of action itself [4, 5, 6]. It has been influentially suggested the reaction time distribution therefore reflects deliberate neural procrastination [7], giving alternative response tendencies sufficient time for fair competition in pursuing a decision threshold that determines which one is behaviorally manifest: a race model, where action selection and execution are closely interrelated [8, 9, 10, 11]. Although the medial frontal cortex exhibits a sensitivity to reaction time on functional imaging that is consistent with such a mechanism [12, 13, 14], direct evidence from disruptive studies has hitherto been lacking. If movement-generating and movement-delaying neural substrates are closely co-localized here, a large-scale lesion will inevitably mask any acceleration, for the movement itself could be disrupted. Circumventing this problem, here we observed focal intracranial electrical disruption of the medial frontal wall in the context of the pre-surgical evaluation of two patients with epilepsy temporarily reversing such hypothesized procrastination. Effector-specific behavioral acceleration, time-locked to the period of electrical disruption, occurred exclusively at a specific locus at the ventral border of the pre-supplementary motor area. A cardinal prediction of race models of voluntary action is thereby substantiated in the human brain.

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Section: Resultsmentioning

confidence: 99%

Reversed Procrastination by Focal Disruption of Medial Frontal Cortex

et al. 2016

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“…43 Monopolar electrodes, with one electrode at the site of interest and a distant reference electrode located on noneloquent cortex, provide a similar ability as the bipolar electrode to elicit a stimulation-induced clinical response, but often requires a higher stimulation intensity to achieve this clinical response compared with the bipolar electrode. 44 The monopolar electrodes were also shown to produce fewer afterdischarges than bipolar electrodes during cortical stimulation and may offer an additional technique for conducting awake craniotomies that may reduce IOS occurrence. 44 Identification of the eloquent cortex via brain mapping in our study was associated with a worse neurologic outcome in the form of new motor deficits.…”

Section: Cortical Mappingmentioning

confidence: 99%

“…44 The monopolar electrodes were also shown to produce fewer afterdischarges than bipolar electrodes during cortical stimulation and may offer an additional technique for conducting awake craniotomies that may reduce IOS occurrence. 44 Identification of the eloquent cortex via brain mapping in our study was associated with a worse neurologic outcome in the form of new motor deficits. We found that most (82.4%) of these new deficits in the PM group were transient and resolved over 1.1 months; 17.6% of these new deficits were permanent.…”

Section: Cortical Mappingmentioning

confidence: 99%

Intraoperative Seizures in Awake Craniotomy for Perirolandic Glioma Resections That Undergo Cortical Mapping

Eseonu

Rincón-Torroella

Lee

et al. 2018

J Neurol Surg A Cent Eur Neurosurg

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Awake craniotomies in the perirolandic motor region can be safely performed with a similar incidence of intraoperative seizures as reported for the language cortex. PM in this region may increase the likelihood of perioperative seizures or motor deficits compared with NM. Craniotomies that minimize cortical exposure for perirolandic gliomas that may not localize motor regions can still allow for extensive tumor resection with a good postoperative outcome.

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“…Note that the concordance between seizures and afterdischarges elicted by DES and the SOZ specifically refers to bipolar stimulation. Comparison of bipolar and monopolar stimulation showed that monopolar stimulation is less likely to trigger afterdischarges [13]. Stimulation during this study was exclusively bipolar.…”

Section: Discussionmentioning

confidence: 70%

Language mapping using electrocorticography versus stereoelectroencephalography: A case series

Young

Coulehan

Fields

et al. 2018

Epilepsy & Behavior

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Direct electrical stimulation (DES) is sometimes used in epilepsy surgery to identify areas that may result in language deficits if resected. Extraoperative language mapping is usually performed using electrocorticography (ECOG) - grids and strip electrodes; however, given the better safety profile of stereoelectroencephalogaphy (SEEG), it would be desirable to determine if mapping using SEEG is also effective. We report a case series of fifteen patients that underwent language mapping with either ECOG (5), SEEG (9), or both (1). Six patients in the SEEG group underwent resection or ablation with only mapping via SEEG. No patients in the SEEG group that underwent resective or ablative surgery experienced persistent language deficits. These results suggest that language mapping with SEEG may be considered as a clinically useful alternative to language mapping with ECOG.

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Comparison of bipolar versus monopolar extraoperative electrical cortical stimulation mapping in patients with focal epilepsy

Cited by 29 publications

References 22 publications

Reversed Procrastination by Focal Disruption of Medial Frontal Cortex

Reversed Procrastination by Focal Disruption of Medial Frontal Cortex

Intraoperative Seizures in Awake Craniotomy for Perirolandic Glioma Resections That Undergo Cortical Mapping

Language mapping using electrocorticography versus stereoelectroencephalography: A case series

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