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Kamada C, Enatsu R, Imataka S, Kanno A, Ochi S, Mikuni N. Functional Brain Mapping Using Depth Electrodes. World Neurosurg 2024:S1878-8750(24)00861-1. [PMID: 38796150 DOI: 10.1016/j.wneu.2024.05.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 05/16/2024] [Accepted: 05/17/2024] [Indexed: 05/28/2024]
Abstract
OBJECTIVE This study investigated the neurologic symptoms and stimulus intensities in the stimulation of deep structures and subcortical fibers with the depth electrodes. METHODS Seventeen patients with drug-refractory epilepsy who underwent functional brain mapping with the depth electrodes were enrolled. The 50 Hz electrical stimulation was applied, and the diffusion tensor image was used to identify subcortical fibers. The responsible structures and stimulus intensities for the induced neurologic symptoms were evaluated. RESULTS Neurologic symptoms were induced in 11 of 17 patients. The opercular stimulation elicited the neurologic symptoms in 6 patients at the median threshold of 4.0 mA (visceral/face/hand sensory, hand/throat motor, negative motor and auditory symptoms). The insular stimulation induced the neurologic symptoms in 4 patients at the median threshold of 4.0 mA (auditory, negative motor, and sensory symptoms). The stimulation of subcortical fibers was induced in 5 of 9 patients at the median threshold of 4.5 mA. The thresholds of depth electrodes were significantly lower than those of subdural electrodes in 8 patients who used both subdural and depth electrodes and induced symptoms with both electrodes. CONCLUSIONS The stimulation of depth electrodes can identify the function of deep structures and subcortical fibers with lower intensities than subdural electrodes.
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Affiliation(s)
- Chie Kamada
- Department of Neurosurgery, Sapporo Medical University, Sapporo, Japan
| | - Rei Enatsu
- Department of Neurosurgery, Sapporo Medical University, Sapporo, Japan.
| | - Seiichiro Imataka
- Department of Neurosurgery, Sapporo Medical University, Sapporo, Japan
| | - Aya Kanno
- Department of Neurosurgery, Sapporo Medical University, Sapporo, Japan
| | - Satoko Ochi
- Department of Neurosurgery, Sapporo Medical University, Sapporo, Japan
| | - Nobuhiro Mikuni
- Department of Neurosurgery, Sapporo Medical University, Sapporo, Japan
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Jedynak M, Boyer A, Mercier M, Chanteloup-Forêt B, Bhattacharjee M, Kahane P, David O. SEEG electrode shaft affects amplitude and latency of potentials evoked with single pulse electrical stimulation. J Neurosci Methods 2024; 403:110035. [PMID: 38128785 DOI: 10.1016/j.jneumeth.2023.110035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 12/07/2023] [Accepted: 12/15/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Long and thin shaft electrodes are implanted intracerebrally for stereoelectroencephalography (SEEG) in patients with pharmacoresistant focal epilepsies. Two adjacent contacts of one of such electrodes can deliver a train of single pulse electrical stimulations (SPES), and evoked potentials (EPs) are recorded on other contacts. In this study we assess if stimulating and recording on the same shaft, as opposed to different shafts, has an impact on common EP features. NEW METHOD We leverage the large volume of SEEG data gathered in the F-TRACT database and analyze data from nearly one thousand SEEG implantations in order to verify whether stimulation and recording from the same shaft influence the EP pattern. RESULTS We found that when the stimulated and the recording contacts were located on the same shaft, the mean and median amplitudes of an EP are greater, and its mean and median latencies are smaller than when the contacts were located on different shafts. This effect is small (Cohen's d ∼ 0.1), but robust (p-value < 10-3) across the SEEG database. COMPARISON WITH EXISTING METHOD(S) Our study is the first one to address this question. Due to the choice of commonly used EP features, our method is congruent with other studies. CONCLUSIONS The magnitude of the reported effect does not obligate all standard analyses to correct for it, unless they aim at high precision. The source of the effect is not clear. Manufacturers of SEEG electrodes could examine it and potentially minimize the effect in their future products.
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Affiliation(s)
- Maciej Jedynak
- Aix Marseille Université, Inserm, INS, Institut de Neurosciences des Systèmes, Marseille, France.
| | - Anthony Boyer
- Aix Marseille Université, Inserm, INS, Institut de Neurosciences des Systèmes, Marseille, France
| | - Manuel Mercier
- Aix Marseille Université, Inserm, INS, Institut de Neurosciences des Systèmes, Marseille, France
| | | | - Manik Bhattacharjee
- Aix Marseille Université, Inserm, INS, Institut de Neurosciences des Systèmes, Marseille, France; Université Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France
| | - Philippe Kahane
- Université Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France; Neurology Department, CHU Grenoble Alpes, Grenoble, France
| | - Olivier David
- Aix Marseille Université, Inserm, INS, Institut de Neurosciences des Systèmes, Marseille, France
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Foutz TJ, Rensing N, Han L, Durand DM, Wong M. Spatial and amplitude dynamics of neurostimulation: Insights from the acute intrahippocampal kainate seizure mouse model. Epilepsia Open 2024; 9:210-222. [PMID: 37926917 PMCID: PMC10839372 DOI: 10.1002/epi4.12861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 10/24/2023] [Indexed: 11/07/2023] Open
Abstract
OBJECTIVE Neurostimulation is an emerging treatment for patients with drug-resistant epilepsy, which is used to suppress, prevent, and terminate seizure activity. Unfortunately, after implantation and despite best clinical practice, most patients continue to have persistent seizures even after years of empirical optimization. The objective of this study is to determine optimal spatial and amplitude properties of neurostimulation in inhibiting epileptiform activity in an acute hippocampal seizure model. METHODS We performed high-throughput testing of high-frequency focal brain stimulation in the acute intrahippocampal kainic acid mouse model of status epilepticus. We evaluated combinations of six anatomic targets and three stimulus amplitudes. RESULTS We found that the spike-suppressive effects of high-frequency neurostimulation are highly dependent on the stimulation amplitude and location, with higher amplitude stimulation being significantly more effective. Epileptiform spiking activity was significantly reduced with ipsilateral 250 μA stimulation of the CA1 and CA3 hippocampal regions with 21.5% and 22.2% reductions, respectively. In contrast, we found that spiking frequency and amplitude significantly increased with stimulation of the ventral hippocampal commissure. We further found spatial differences with broader effects from CA1 versus CA3 stimulation. SIGNIFICANCE These findings demonstrate that the effects of therapeutic neurostimulation in an acute hippocampal seizure model are highly dependent on the location of stimulation and stimulus amplitude. We provide a platform to optimize the anti-seizure effects of neurostimulation, and demonstrate that an exploration of the large electrical parameter and location space can improve current modalities for treating epilepsy. PLAIN LANGUAGE SUMMARY In this study, we tested how electrical pulses in the brain can help control seizures in mice. We found that the electrode's placement and the stimulation amplitude had a large effect on outcomes. Some brain regions, notably nearby CA1 and CA3, responded positively with reduced seizure-like activities, while others showed increased activity. These findings emphasize that choosing the right spot for the electrode and adjusting the strength of electrical pulses are both crucial when considering neurostimulation treatments for epilepsy.
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Affiliation(s)
- Thomas J. Foutz
- Department of NeurologyWashington University School of MedicineSt. LouisMissouriUSA
| | - Nicholas Rensing
- Department of NeurologyWashington University School of MedicineSt. LouisMissouriUSA
| | - Lirong Han
- Department of NeurologyWashington University School of MedicineSt. LouisMissouriUSA
| | - Dominique M. Durand
- Department of Biomedical EngineeringCase Western Reserve UniversityClevelandOhioUSA
| | - Michael Wong
- Department of NeurologyWashington University School of MedicineSt. LouisMissouriUSA
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Frauscher B, Bartolomei F, Baud MO, Smith RJ, Worrell G, Lundstrom BN. Stimulation to probe, excite, and inhibit the epileptic brain. Epilepsia 2023; 64 Suppl 3:S49-S61. [PMID: 37194746 PMCID: PMC10654261 DOI: 10.1111/epi.17640] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 05/01/2023] [Accepted: 05/02/2023] [Indexed: 05/18/2023]
Abstract
Direct cortical stimulation has been applied in epilepsy for nearly a century and has experienced a renaissance, given unprecedented opportunities to probe, excite, and inhibit the human brain. Evidence suggests stimulation can increase diagnostic and therapeutic utility in patients with drug-resistant epilepsies. However, choosing appropriate stimulation parameters is not a trivial issue, and is further complicated by epilepsy being characterized by complex brain state dynamics. In this article derived from discussions at the ICTALS 2022 Conference (International Conference on Technology and Analysis for Seizures), we succinctly review the literature on cortical stimulation applied acutely and chronically to the epileptic brain for localization, monitoring, and therapeutic purposes. In particular, we discuss how stimulation is used to probe brain excitability, discuss evidence on the usefulness of stimulation to trigger and stop seizures, review therapeutic applications of stimulation, and finally discuss how stimulation parameters are impacted by brain dynamics. Although research has advanced considerably over the past decade, there are still significant hurdles to optimizing use of this technique. For example, it remains unclear to what extent short timescale diagnostic biomarkers can predict long-term outcomes and to what extent these biomarkers add information to already existing biomarkers from passive electroencephalographic recordings. Further questions include the extent to which closed loop stimulation offers advantages over open loop stimulation, what the optimal closed loop timescales may be, and whether biomarker-informed stimulation can lead to seizure freedom. The ultimate goal of bioelectronic medicine remains not just to stop seizures but rather to cure epilepsy and its comorbidities.
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Affiliation(s)
- Birgit Frauscher
- Analytical Neurophysiology Lab, Montreal Neurological Institute and Hospital, Montreal, Quebec, Canada
| | - Fabrice Bartolomei
- Institut de Neurosciences des Systèmes, Aix Marseille University, Marseille, France. AP-HM, Service de Neurophysiologie Clinique, Hôpital de la Timone, Marseille, France
| | - Maxime O. Baud
- Sleep-Wake-Epilepsy Center, NeuroTec and Center for Experimental Neurology, Department of Neurology, Inselspital Bern, University Hospital, University of Bern, Bern
| | - Rachel J. Smith
- University of Alabama at Birmingham, Electrical and Computer Engineering Department, Birmingham, Alabama, US. University of Alabama at Birmingham, Neuroengineering Program, Birmingham, Alabama, US
| | - Greg Worrell
- Department of Neurology, Mayo Clinic, Rochester, US
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Hays MA, Kamali G, Koubeissi MZ, Sarma SV, Crone NE, Smith RJ, Kang JY. Towards optimizing single pulse electrical stimulation: High current intensity, short pulse width stimulation most effectively elicits evoked potentials. Brain Stimul 2023; 16:772-782. [PMID: 37141936 PMCID: PMC10330807 DOI: 10.1016/j.brs.2023.04.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 04/21/2023] [Accepted: 04/26/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND While single pulse electrical stimulation (SPES) is increasingly used to study effective connectivity, the effects of varying stimulation parameters on the resulting cortico-cortical evoked potentials (CCEPs) have not been systematically explored. OBJECTIVE We sought to understand the interacting effects of stimulation pulse width, current intensity, and charge on CCEPs through an extensive testing of this parameter space and analysis of several response metrics. METHODS We conducted SPES in 11 patients undergoing intracranial EEG monitoring using five combinations of current intensity (1.5, 2.0, 3.0, 5.0, and 7.5 mA) and pulse width at each of three charges (0.750, 1.125, and 1.500 μC/phase) to study how CCEP amplitude, distribution, latency, morphology, and stimulus artifact amplitude vary with each parameter. RESULTS Stimulations with a greater charge or a greater current intensity and shorter pulse width at a given charge generally resulted in greater CCEP amplitudes and spatial distributions, shorter latencies, and increased waveform correlation. These effects interacted such that stimulations with the lowest charge and highest current intensities resulted in greater response amplitudes and spatial distributions than stimulations with the highest charge and lowest current intensities. Stimulus artifact amplitude increased with charge, but this could be mitigated by using shorter pulse widths. CONCLUSIONS Our results indicate that individual combinations of current intensity and pulse width, in addition to charge, are important determinants of CCEP magnitude, morphology, and spatial extent. Together, these findings suggest that high current intensity, short pulse width stimulations are optimal SPES settings for eliciting strong and consistent responses while minimizing charge.
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Affiliation(s)
- Mark A Hays
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA.
| | - Golnoosh Kamali
- Johns Hopkins Technology Ventures, Johns Hopkins University, Baltimore, MD, USA
| | | | - Sridevi V Sarma
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA; Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Nathan E Crone
- Department of Neurology, Johns Hopkins University, Baltimore, MD, USA
| | - Rachel J Smith
- Department of Electrical and Computer Engineering, University of Alabama at Birmingham, Birmingham, AL, USA; Department of Neuroengineering, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Joon Y Kang
- Department of Neurology, Johns Hopkins University, Baltimore, MD, USA
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Foutz TJ, Rensing N, Han L, Durand DM, Wong M. Spatial and Amplitude Dynamics of Neurostimulation: Insights from the Acute Intrahippocampal Kainate Seizure Mouse Model. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.03.07.531440. [PMID: 36945383 PMCID: PMC10028881 DOI: 10.1101/2023.03.07.531440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
Objective Neurostimulation is an emerging treatment for patients with medically refractory epilepsy, which is used to suppress, prevent, and terminate seizure activity. Unfortunately, after implantation and despite best clinical practice, most patients continue to have persistent seizures even after years of empirical optimization. The objective of this study is to determine optimal spatial and amplitude properties of neurostimulation in inhibiting epileptiform activity in an acute hippocampal seizure model. Methods We performed high-throughput testing of high-frequency focal brain stimulation in the acute intrahippocampal kainic acid mouse model of temporal lobe epilepsy. We evaluated combinations of six anatomic targets and three stimulus amplitudes. Results We found that the spike-suppressive effects of high-frequency neurostimulation are highly dependent on the stimulation amplitude and location, with higher amplitude stimulation being significantly more effective. Epileptiform spiking activity was significantly reduced with ipsilateral 250 μA stimulation of the CA1 and CA3 hippocampal regions with 21.5% and 22.2% reductions, respectively. In contrast, we found that spiking frequency and amplitude significantly increased with stimulation of the ventral hippocampal commissure. We further found spatial differences with broader effects from CA1 versus CA3 stimulation. Significance These findings demonstrate that the effects of therapeutic neurostimulation in an acute hippocampal seizure model are highly dependent on the location of stimulation and stimulus amplitude. We provide a platform to optimize the anti-seizure effects of neurostimulation, and demonstrate that an exploration of the large electrical parameter and location space can improve current modalities for treating epilepsy. Key Points Evaluated spatial and temporal parameters of neurostimulation in a mouse model of acute seizuresBrief bursts of high-frequency (100 Hz) stimulation effectively interrupted epileptiform activity.The suppressive effect was highly dependent on stimulation amplitude and was maximal at the ipsilateral CA1 and CA3 regions.Pro-excitatory effects were identified with high-amplitude high-frequency stimulation at the ventral hippocampal commissure and contralateral CA1.
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Jedynak M, Boyer A, Chanteloup-Forêt B, Bhattacharjee M, Saubat C, Tadel F, Kahane P, David O. Variability of Single Pulse Electrical Stimulation Responses Recorded with Intracranial Electroencephalography in Epileptic Patients. Brain Topogr 2023; 36:119-127. [PMID: 36520342 PMCID: PMC9834344 DOI: 10.1007/s10548-022-00928-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 11/09/2022] [Indexed: 12/23/2022]
Abstract
Cohort studies of brain stimulations performed with stereo-electroencephalographic (SEEG) electrodes in epileptic patients allow to derive large scale functional connectivity. It is known, however, that brain responses to electrical or magnetic stimulation techniques are not always reproducible. Here, we study variability of responses to single pulse SEEG electrical stimulation. We introduce a second-order probability analysis, i.e. we extend estimation of connection probabilities, defined as the proportion of responses trespassing a statistical threshold (determined in terms of Z-score with respect to spontaneous neuronal activity before stimulation) over all responses and derived from a number of individual measurements, to an analysis of pairs of measurements.Data from 445 patients were processed. We found that variability between two equivalent measurements is substantial in particular conditions. For long ( > ~ 90 mm) distances between stimulating and recording sites, and threshold value Z = 3, correlation between measurements drops almost to zero. In general, it remains below 0.5 when the threshold is smaller than Z = 4 or the stimulating current intensity is 1 mA. It grows with an increase of either of these factors. Variability is independent of interictal spiking rates in the stimulating and recording sites.We conclude that responses to SEEG stimulation in the human brain are variable, i.e. in a subject at rest, two stimulation trains performed at the same electrode contacts and with the same protocol can give discrepant results. Our findings highlight an advantage of probabilistic interpretation of such results even in the context of a single individual.
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Affiliation(s)
- Maciej Jedynak
- Grenoble Institut Neurosciences, Université Grenoble Alpes, Inserm, U1216, 38000, Grenoble, France.
- Aix Marseille Université, Inserm, INS, Institut de Neurosciences des Systèmes, Marseille, France.
| | - Anthony Boyer
- Grenoble Institut Neurosciences, Université Grenoble Alpes, Inserm, U1216, 38000, Grenoble, France
- Aix Marseille Université, Inserm, INS, Institut de Neurosciences des Systèmes, Marseille, France
| | | | - Manik Bhattacharjee
- Grenoble Institut Neurosciences, Université Grenoble Alpes, Inserm, U1216, 38000, Grenoble, France
- Aix Marseille Université, Inserm, INS, Institut de Neurosciences des Systèmes, Marseille, France
| | - Carole Saubat
- Grenoble Institut Neurosciences, Université Grenoble Alpes, Inserm, U1216, 38000, Grenoble, France
| | - François Tadel
- Grenoble Institut Neurosciences, Université Grenoble Alpes, Inserm, U1216, 38000, Grenoble, France
- Signal and Image Processing Institute, University of Southern California, Los Angeles, USA
| | - Philippe Kahane
- Grenoble Institut Neurosciences, Université Grenoble Alpes, Inserm, U1216, 38000, Grenoble, France
- Neurology Department, CHU Grenoble Alpes, Grenoble, France
| | - Olivier David
- Grenoble Institut Neurosciences, Université Grenoble Alpes, Inserm, U1216, 38000, Grenoble, France
- Aix Marseille Université, Inserm, INS, Institut de Neurosciences des Systèmes, Marseille, France
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8
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Hays MA, Smith RJ, Wang Y, Coogan C, Sarma SV, Crone NE, Kang JY. Cortico-cortical evoked potentials in response to varying stimulation intensity improves seizure localization. Clin Neurophysiol 2023; 145:119-128. [PMID: 36127246 PMCID: PMC9771930 DOI: 10.1016/j.clinph.2022.08.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 08/05/2022] [Accepted: 08/27/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE As single pulse electrical stimulation (SPES) is increasingly utilized to help localize the seizure onset zone (SOZ), it is important to understand how stimulation intensity can affect the ability to use cortico-cortical evoked potentials (CCEPs) to delineate epileptogenic regions. METHODS We studied 15 drug-resistant epilepsy patients undergoing intracranial EEG monitoring and SPES with titrations of stimulation intensity. The N1 amplitude and distribution of CCEPs elicited in the SOZ and non-seizure onset zone (nSOZ) were quantified at each intensity. The separability of the SOZ and nSOZ using N1 amplitudes was compared between models using responses to titrations, responses to one maximal intensity, or both. RESULTS At 2 mA and above, the increase in N1 amplitude with current intensity was greater for responses within the SOZ, and SOZ response distribution was maximized by 4-6 mA. Models incorporating titrations achieved better separability of SOZ and nSOZ compared to those using one maximal intensity. CONCLUSIONS We demonstrated that differences in CCEP amplitude over a range of current intensities can improve discriminability of SOZ regions. SIGNIFICANCE This study provides insight into the underlying excitability of the SOZ and how differences in current-dependent amplitudes of CCEPs may be used to help localize epileptogenic sites.
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Affiliation(s)
- Mark A Hays
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Rachel J Smith
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Yujing Wang
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Christopher Coogan
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sridevi V Sarma
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Nathan E Crone
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Joon Y Kang
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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9
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Samanta D. Recent developments in stereo electroencephalography monitoring for epilepsy surgery. Epilepsy Behav 2022; 135:108914. [PMID: 36116362 DOI: 10.1016/j.yebeh.2022.108914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 08/31/2022] [Accepted: 09/02/2022] [Indexed: 11/03/2022]
Abstract
Recently the utilization of the stereo electroencephalography (SEEG) method has exploded globally. It is now the preferred method of intracranial monitoring for epilepsy. Since its inception, the basic tenet of the SEEG method remains the same: strategic implantation of intracerebral electrodes based on a hypothesis grounded on anatomo-electroclinical correlation, interpretation of interictal and ictal abnormalities, and formation of a surgical plan based on these data. However, there are recent advancements in all these domains-electrodes implantations, data interpretation, and therapeutic strategy- that can make the SEEG a more accessible and effective approach. In this narrative review, these newer developments are discussed and summarized. Regarding implantation, efficient commercial robotic systems are now increasingly available, which are also more accurate in implanting electrodes. In terms of ictal and interictal abnormalities, newer studies focused on correlating these abnormalities with pathological substrates and surgical outcomes and analyzing high-frequency oscillations and cortical-subcortical connectivity. These abnormalities can now be further quantified using advanced tools (spectrum, spatiotemporal, connectivity analysis, and machine learning algorithms) for objective and efficient interpretation. Another aspect of recent development is renewed interest in SEEG-based electrical stimulation mapping (ESM). The SEEG-ESM has been used in defining epileptogenic networks, mapping eloquent cortex (primarily language), and analyzing cortico-cortical evoked potential. Regarding SEEG-guided direct therapeutic strategy, several clinical studies evaluated the use of radiofrequency thermocoagulation. As the emerging SEEG-based diagnosis and therapeutics are better evolved, treatments aimed at specific epileptogenic networks without compromising the eloquent cortex will become more easily accessible to improve the lives of individuals with drug-resistant epilepsy (DRE).
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Affiliation(s)
- Debopam Samanta
- Neurology Division, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States.
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10
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Parmigiani S, Mikulan EP, Russo S, Sarasso S, Zauli FM, Rubino A, Cattani A, Fecchio M, Giampiccolo D, Lanzone J, D'Orio P, Del Vecchio M, Avanzini P, Nobili L, Sartori I, Massimini M, Pigorini A. Simultaneous stereo-EEG and high-density scalp EEG recordings to study the effects of intracerebral stimulation parameters. Brain Stimul 2022; 15:664-675. [PMID: 35421585 DOI: 10.1016/j.brs.2022.04.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 04/06/2022] [Accepted: 04/06/2022] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Cortico-cortical evoked potentials (CCEPs) recorded by stereo-electroencephalography (SEEG) are a valuable tool to investigate brain reactivity and effective connectivity. However, invasive recordings are spatially sparse since they depend on clinical needs. This sparsity hampers systematic comparisons across-subjects, the detection of the whole-brain effects of intracortical stimulation, as well as their relationships to the EEG responses evoked by non-invasive stimuli. OBJECTIVE To demonstrate that CCEPs recorded by high-density electroencephalography (hd-EEG) provide additional information with respect SEEG alone and to provide an open, curated dataset to allow for further exploration of their potential. METHODS The dataset encompasses SEEG and hd-EEG recordings simultaneously acquired during Single Pulse Electrical Stimulation (SPES) in drug-resistant epileptic patients (N = 36) in whom stimulations were delivered with different physical, geometrical, and topological parameters. Differences in CCEPs were assessed by amplitude, latency, and spectral measures. RESULTS While invasively and non-invasively recorded CCEPs were generally correlated, differences in pulse duration, angle and stimulated cortical area were better captured by hd-EEG. Further, intracranial stimulation evoked site-specific hd-EEG responses that reproduced the spectral features of EEG responses to transcranial magnetic stimulation (TMS). Notably, SPES, albeit unperceived by subjects, elicited scalp responses that were up to one order of magnitude larger than the responses typically evoked by sensory stimulation in awake humans. CONCLUSIONS CCEPs can be simultaneously recorded with SEEG and hd-EEG and the latter provides a reliable descriptor of the effects of SPES as well as a common reference to compare the whole-brain effects of intracortical stimulation to those of non-invasive transcranial or sensory stimulations in humans.
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Affiliation(s)
- S Parmigiani
- Department of Biomedical and Clinical Sciences "L. Sacco" Università degli Studi di Milano, Milan, Italy
| | - E P Mikulan
- Department of Biomedical and Clinical Sciences "L. Sacco" Università degli Studi di Milano, Milan, Italy
| | - S Russo
- Department of Biomedical and Clinical Sciences "L. Sacco" Università degli Studi di Milano, Milan, Italy; Department of Philosophy "Piero Martinetti", Università degli Studi di Milano, Milan, Italy
| | - S Sarasso
- Department of Biomedical and Clinical Sciences "L. Sacco" Università degli Studi di Milano, Milan, Italy
| | - F M Zauli
- Department of Biomedical and Clinical Sciences "L. Sacco" Università degli Studi di Milano, Milan, Italy; Department of Philosophy "Piero Martinetti", Università degli Studi di Milano, Milan, Italy
| | - A Rubino
- "C. Munari" Epilepsy Surgery Centre, Department of Neuroscience, Niguarda Hospital, Milan, Italy
| | - A Cattani
- Department of Mathematics & Statistics, Boston University, Boston, MA, USA
| | - M Fecchio
- Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - D Giampiccolo
- Department of Neurosurgery, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy; Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, UK; Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK; Institute of Neurosciences, Cleveland Clinic London, London, UK
| | - J Lanzone
- Department of Systems Medicine, Neuroscience, University of Rome Tor Vergata, Rome, Italy; Istituti Clinici Scientifici Maugeri, IRCCS, Neurorehabilitation Department of Milano Institute, Milan, Italy
| | - P D'Orio
- "C. Munari" Epilepsy Surgery Centre, Department of Neuroscience, Niguarda Hospital, Milan, Italy; Istituto di Neuroscienze, Consiglio Nazionale delle Ricerche, Parma, Italy
| | - M Del Vecchio
- Istituto di Neuroscienze, Consiglio Nazionale delle Ricerche, Parma, Italy
| | - P Avanzini
- Istituto di Neuroscienze, Consiglio Nazionale delle Ricerche, Parma, Italy
| | - L Nobili
- Child Neuropsychiatry, IRCCS Istituto G. Gaslini, Genova, Italy
| | - I Sartori
- "C. Munari" Epilepsy Surgery Centre, Department of Neuroscience, Niguarda Hospital, Milan, Italy
| | - M Massimini
- Department of Biomedical and Clinical Sciences "L. Sacco" Università degli Studi di Milano, Milan, Italy; Istituto Di Ricovero e Cura a Carattere Scientifico, Fondazione Don Carlo Gnocchi, Milan, Italy; Azrieli Program in Brain, Mind and Consciousness, Canadian Institute for Advanced Research, Toronto, Canada
| | - A Pigorini
- Department of Biomedical and Clinical Sciences "L. Sacco" Università degli Studi di Milano, Milan, Italy; Department of Biomedical, V, Università degli Studi di Milano, Milan, Italy.
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11
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Paulk AC, Zelmann R, Crocker B, Widge AS, Dougherty DD, Eskandar EN, Weisholtz DS, Richardson RM, Cosgrove GR, Williams ZM, Cash SS. Local and distant cortical responses to single pulse intracranial stimulation in the human brain are differentially modulated by specific stimulation parameters. Brain Stimul 2022; 15:491-508. [PMID: 35247646 PMCID: PMC8985164 DOI: 10.1016/j.brs.2022.02.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 02/23/2022] [Accepted: 02/24/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Electrical neuromodulation via direct electrical stimulation (DES) is an increasingly common therapy for a wide variety of neuropsychiatric diseases. Unfortunately, therapeutic efficacy is inconsistent, likely due to our limited understanding of the relationship between the massive stimulation parameter space and brain tissue responses. OBJECTIVE To better understand how different parameters induce varied neural responses, we systematically examined single pulse-induced cortico-cortico evoked potentials (CCEP) as a function of stimulation amplitude, duration, brain region, and whether grey or white matter was stimulated. METHODS We measured voltage peak amplitudes and area under the curve (AUC) of intracranially recorded stimulation responses as a function of distance from the stimulation site, pulse width, current injected, location relative to grey and white matter, and brain region stimulated (N = 52, n = 719 stimulation sites). RESULTS Increasing stimulation pulse width increased responses near the stimulation location. Increasing stimulation amplitude (current) increased both evoked amplitudes and AUC nonlinearly. Locally (<15 mm), stimulation at the boundary between grey and white matter induced larger responses. In contrast, for distant sites (>15 mm), white matter stimulation consistently produced larger responses than stimulation in or near grey matter. The stimulation location-response curves followed different trends for cingulate, lateral frontal, and lateral temporal cortical stimulation. CONCLUSION These results demonstrate that a stronger local response may require stimulation in the grey-white boundary while stimulation in the white matter could be needed for network activation. Thus, stimulation parameters tailored for a specific anatomical-functional outcome may be key to advancing neuromodulatory therapy.
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Affiliation(s)
- Angelique C Paulk
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA; Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
| | - Rina Zelmann
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA; Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Britni Crocker
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA; Harvard-MIT Health Sciences and Technology, Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Alik S Widge
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, 02129, USA
| | - Darin D Dougherty
- Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, 02129, USA
| | - Emad N Eskandar
- Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA
| | - Daniel S Weisholtz
- Department of Neurology, Brigham and Women's Hospital, Boston, MA, 02114, USA
| | - R Mark Richardson
- Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA; Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA
| | - G Rees Cosgrove
- Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA, 02114, USA
| | - Ziv M Williams
- Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA; Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA
| | - Sydney S Cash
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA; Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
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12
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Tchoe Y, Bourhis AM, Cleary DR, Stedelin B, Lee J, Tonsfeldt KJ, Brown EC, Siler DA, Paulk AC, Yang JC, Oh H, Ro YG, Lee K, Russman SM, Ganji M, Galton I, Ben-Haim S, Raslan AM, Dayeh SA. Human brain mapping with multithousand-channel PtNRGrids resolves spatiotemporal dynamics. Sci Transl Med 2022; 14:eabj1441. [PMID: 35044788 DOI: 10.1126/scitranslmed.abj1441] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Electrophysiological devices are critical for mapping eloquent and diseased brain regions and for therapeutic neuromodulation in clinical settings and are extensively used for research in brain-machine interfaces. However, the existing clinical and experimental devices are often limited in either spatial resolution or cortical coverage. Here, we developed scalable manufacturing processes with a dense electrical connection scheme to achieve reconfigurable thin-film, multithousand-channel neurophysiological recording grids using platinum nanorods (PtNRGrids). With PtNRGrids, we have achieved a multithousand-channel array of small (30 μm) contacts with low impedance, providing high spatial and temporal resolution over a large cortical area. We demonstrated that PtNRGrids can resolve submillimeter functional organization of the barrel cortex in anesthetized rats that captured the tissue structure. In the clinical setting, PtNRGrids resolved fine, complex temporal dynamics from the cortical surface in an awake human patient performing grasping tasks. In addition, the PtNRGrids identified the spatial spread and dynamics of epileptic discharges in a patient undergoing epilepsy surgery at 1-mm spatial resolution, including activity induced by direct electrical stimulation. Collectively, these findings demonstrated the power of the PtNRGrids to transform clinical mapping and research with brain-machine interfaces.
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Affiliation(s)
- Youngbin Tchoe
- Integrated Electronics and Biointerfaces Laboratory, Department of Electrical and Computer Engineering, University of California San Diego, La Jolla, CA 92093, USA
| | - Andrew M Bourhis
- Integrated Electronics and Biointerfaces Laboratory, Department of Electrical and Computer Engineering, University of California San Diego, La Jolla, CA 92093, USA
| | - Daniel R Cleary
- Integrated Electronics and Biointerfaces Laboratory, Department of Electrical and Computer Engineering, University of California San Diego, La Jolla, CA 92093, USA.,Department of Neurological Surgery, University of California San Diego, La Jolla, CA 92093, USA
| | - Brittany Stedelin
- Department of Neurological Surgery, Oregon Health and Science University, Portland, OR 97239, USA
| | - Jihwan Lee
- Integrated Electronics and Biointerfaces Laboratory, Department of Electrical and Computer Engineering, University of California San Diego, La Jolla, CA 92093, USA
| | - Karen J Tonsfeldt
- Integrated Electronics and Biointerfaces Laboratory, Department of Electrical and Computer Engineering, University of California San Diego, La Jolla, CA 92093, USA.,Department of Obstetrics, Gynecology, and Reproductive Sciences, Center for Reproductive Science and Medicine, University of California San Diego, La Jolla, CA 92093, USA
| | - Erik C Brown
- Department of Neurological Surgery, Oregon Health and Science University, Portland, OR 97239, USA
| | - Dominic A Siler
- Department of Neurological Surgery, Oregon Health and Science University, Portland, OR 97239, USA
| | - Angelique C Paulk
- Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Jimmy C Yang
- Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA.,Department of Neurosurgery, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Hongseok Oh
- Integrated Electronics and Biointerfaces Laboratory, Department of Electrical and Computer Engineering, University of California San Diego, La Jolla, CA 92093, USA
| | - Yun Goo Ro
- Integrated Electronics and Biointerfaces Laboratory, Department of Electrical and Computer Engineering, University of California San Diego, La Jolla, CA 92093, USA
| | - Keundong Lee
- Integrated Electronics and Biointerfaces Laboratory, Department of Electrical and Computer Engineering, University of California San Diego, La Jolla, CA 92093, USA
| | - Samantha M Russman
- Integrated Electronics and Biointerfaces Laboratory, Department of Electrical and Computer Engineering, University of California San Diego, La Jolla, CA 92093, USA
| | - Mehran Ganji
- Integrated Electronics and Biointerfaces Laboratory, Department of Electrical and Computer Engineering, University of California San Diego, La Jolla, CA 92093, USA
| | - Ian Galton
- Integrated Electronics and Biointerfaces Laboratory, Department of Electrical and Computer Engineering, University of California San Diego, La Jolla, CA 92093, USA
| | - Sharona Ben-Haim
- Integrated Electronics and Biointerfaces Laboratory, Department of Electrical and Computer Engineering, University of California San Diego, La Jolla, CA 92093, USA.,Department of Neurological Surgery, University of California San Diego, La Jolla, CA 92093, USA
| | - Ahmed M Raslan
- Department of Neurological Surgery, Oregon Health and Science University, Portland, OR 97239, USA
| | - Shadi A Dayeh
- Integrated Electronics and Biointerfaces Laboratory, Department of Electrical and Computer Engineering, University of California San Diego, La Jolla, CA 92093, USA.,Department of Neurological Surgery, University of California San Diego, La Jolla, CA 92093, USA.,Graduate Program of Materials Science and Engineering, University of California San Diego, La Jolla, CA 92093, USA
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13
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Barborica A, Oane I, Donos C, Daneasa A, Mihai F, Pistol C, Dabu A, Roceanu A, Mindruta I. Imaging the effective networks associated with cortical function through intracranial high-frequency stimulation. Hum Brain Mapp 2021; 43:1657-1675. [PMID: 34904772 PMCID: PMC8886668 DOI: 10.1002/hbm.25749] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 12/01/2021] [Accepted: 12/02/2021] [Indexed: 01/23/2023] Open
Abstract
Direct electrical stimulation (DES) is considered to be the gold standard for mapping cortical function. A careful mapping of the eloquent cortex is key to successful resective or ablative surgeries, with a minimal postoperative deficit, for treatment of drug‐resistant epilepsy. There is accumulating evidence suggesting that not only local, but also remote activations play an equally important role in evoking clinical effects. By introducing a new intracranial stimulation paradigm and signal analysis methodology allowing to disambiguate EEG responses from stimulation artifacts we highlight the spatial extent of the networks associated with clinical effects. Our study includes 26 patients that underwent stereoelectroencephalographic investigations for drug‐resistant epilepsy, having 337 depth electrodes with 4,351 contacts sampling most brain structures. The routine high‐frequency electrical stimulation protocol for eloquent cortex mapping was altered in a subtle way, by alternating the polarity of the biphasic pulses in a train, causing the splitting the spectral lines of the artifactual components, exposing the underlying tissue response. By performing a frequency‐domain analysis of the EEG responses during DES we were able to capture remote activations and highlight the effect's network. By using standard intersubject averaging and a fine granularity HCP‐MMP parcellation, we were able to create local and distant connectivity maps for 614 stimulations evoking specific clinical effects. The clinical value of such maps is not only for a better understanding of the extent of the effects' networks guiding the invasive exploration, but also for understanding the spatial patterns of seizure propagation given the timeline of the seizure semiology.
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Affiliation(s)
- Andrei Barborica
- Physics Department, University of Bucharest, Bucharest, Romania.,FHC Inc., Bowdoin, Maine, USA
| | - Irina Oane
- Epilepsy Monitoring Unit, Neurology Department, Emergency University Hospital Bucharest, Bucharest, Romania
| | - Cristian Donos
- Physics Department, University of Bucharest, Bucharest, Romania
| | - Andrei Daneasa
- Epilepsy Monitoring Unit, Neurology Department, Emergency University Hospital Bucharest, Bucharest, Romania
| | - Felicia Mihai
- Physics Department, University of Bucharest, Bucharest, Romania
| | | | - Aurelia Dabu
- Epilepsy Monitoring Unit, Neurology Department, Emergency University Hospital Bucharest, Bucharest, Romania
| | - Adina Roceanu
- Epilepsy Monitoring Unit, Neurology Department, Emergency University Hospital Bucharest, Bucharest, Romania
| | - Ioana Mindruta
- Epilepsy Monitoring Unit, Neurology Department, Emergency University Hospital Bucharest, Bucharest, Romania.,Neurology Department, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy Bucharest, Bucharest, Romania
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14
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Lemaréchal JD, Jedynak M, Trebaul L, Boyer A, Tadel F, Bhattacharjee M, Deman P, Tuyisenge V, Ayoubian L, Hugues E, Chanteloup-Forêt B, Saubat C, Zouglech R, Reyes Mejia GC, Tourbier S, Hagmann P, Adam C, Barba C, Bartolomei F, Blauwblomme T, Curot J, Dubeau F, Francione S, Garcés M, Hirsch E, Landré E, Liu S, Maillard L, Metsähonkala EL, Mindruta I, Nica A, Pail M, Petrescu AM, Rheims S, Rocamora R, Schulze-Bonhage A, Szurhaj W, Taussig D, Valentin A, Wang H, Kahane P, George N, David O. A brain atlas of axonal and synaptic delays based on modelling of cortico-cortical evoked potentials. Brain 2021; 145:1653-1667. [PMID: 35416942 PMCID: PMC9166555 DOI: 10.1093/brain/awab362] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 08/03/2021] [Accepted: 08/14/2021] [Indexed: 11/16/2022] Open
Abstract
Epilepsy presurgical investigation may include focal intracortical single-pulse electrical stimulations with depth electrodes, which induce cortico-cortical evoked potentials at distant sites because of white matter connectivity. Cortico-cortical evoked potentials provide a unique window on functional brain networks because they contain sufficient information to infer dynamical properties of large-scale brain connectivity, such as preferred directionality and propagation latencies. Here, we developed a biologically informed modelling approach to estimate the neural physiological parameters of brain functional networks from the cortico-cortical evoked potentials recorded in a large multicentric database. Specifically, we considered each cortico-cortical evoked potential as the output of a transient stimulus entering the stimulated region, which directly propagated to the recording region. Both regions were modelled as coupled neural mass models, the parameters of which were estimated from the first cortico-cortical evoked potential component, occurring before 80 ms, using dynamic causal modelling and Bayesian model inversion. This methodology was applied to the data of 780 patients with epilepsy from the F-TRACT database, providing a total of 34 354 bipolar stimulations and 774 445 cortico-cortical evoked potentials. The cortical mapping of the local excitatory and inhibitory synaptic time constants and of the axonal conduction delays between cortical regions was obtained at the population level using anatomy-based averaging procedures, based on the Lausanne2008 and the HCP-MMP1 parcellation schemes, containing 130 and 360 parcels, respectively. To rule out brain maturation effects, a separate analysis was performed for older (>15 years) and younger patients (<15 years). In the group of older subjects, we found that the cortico-cortical axonal conduction delays between parcels were globally short (median = 10.2 ms) and only 16% were larger than 20 ms. This was associated to a median velocity of 3.9 m/s. Although a general lengthening of these delays with the distance between the stimulating and recording contacts was observed across the cortex, some regions were less affected by this rule, such as the insula for which almost all efferent and afferent connections were faster than 10 ms. Synaptic time constants were found to be shorter in the sensorimotor, medial occipital and latero-temporal regions, than in other cortical areas. Finally, we found that axonal conduction delays were significantly larger in the group of subjects younger than 15 years, which corroborates that brain maturation increases the speed of brain dynamics. To our knowledge, this study is the first to provide a local estimation of axonal conduction delays and synaptic time constants across the whole human cortex in vivo, based on intracerebral electrophysiological recordings.
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Affiliation(s)
- Jean-Didier Lemaréchal
- Sorbonne Université, Institut du Cerveau-Paris Brain Institute-ICM, Inserm, CNRS, Centre MEG-EEG and Experimental Neurosurgery Team, F-75013 Paris, France.,Université Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France.,Aix Marseille Université, Inserm, INS, Institut de Neurosciences des Systèmes, Marseille, France
| | - Maciej Jedynak
- Université Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France
| | - Lena Trebaul
- Université Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France
| | - Anthony Boyer
- Université Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France
| | - François Tadel
- Université Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France
| | - Manik Bhattacharjee
- Université Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France
| | - Pierre Deman
- Université Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France
| | - Viateur Tuyisenge
- Université Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France
| | - Leila Ayoubian
- Université Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France
| | - Etienne Hugues
- Université Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France
| | | | - Carole Saubat
- Université Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France
| | - Raouf Zouglech
- Université Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France
| | | | - Sébastien Tourbier
- Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Patric Hagmann
- Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Claude Adam
- Department of Neurology, Epilepsy Unit, AP-HP, Hôpital de la Pitié Salpêtrière, F-75013 Paris, France
| | - Carmen Barba
- Neuroscience Department, Children's Hospital Meyer-University of Florence, Florence, Italy
| | - Fabrice Bartolomei
- Aix Marseille Université, Inserm, INS, Institut de Neurosciences des Systèmes, Marseille, France.,Service de Neurophysiologie Clinique, APHM, Hôpitaux de la Timone, Marseille, France
| | - Thomas Blauwblomme
- Department of Pediatric Neurosurgery, Hôpital Necker-Enfants Malades, Université Paris V Descartes, Sorbonne Paris Cité, Paris, France
| | - Jonathan Curot
- Department of Neurophysiological Explorations, CerCo, CNRS, UMR5549, Centre Hospitalier Universitaire de Toulouse and University of Toulouse, Toulouse, France
| | - François Dubeau
- Montreal Neurological Institute and Hospital, Montreal, Canada
| | - Stefano Francione
- 'Claudio Munari' Centre for Epilepsy Surgery; Neuroscience Department, GOM, Niguarda, Milano, Italy
| | - Mercedes Garcés
- Multidisciplinary Epilepsy Unit, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Edouard Hirsch
- University Hospital, Department of Neurology, Strasbourg, France
| | | | - Sinclair Liu
- Canton Sanjiu Brain Hospital Epilepsy Center, Jinan University, Guangzhou, China
| | - Louis Maillard
- Centre Hospitalier Universitaire de Nancy, Nancy, France
| | | | - Ioana Mindruta
- Neurology Department, University Emergency Hospital, Bucharest, Romania
| | - Anca Nica
- Neurology Department, CIC 1414, Rennes University Hospital; LTSI, INSERM U 1099, F-35000 Rennes, France
| | - Martin Pail
- Brno Epilepsy Center, Department of Neurology, St. Anne's University Hospital and Medical Faculty of Masaryk University, Brno, Czech Republic
| | | | - Sylvain Rheims
- Department of Functional Neurology and Epileptology, Hospices Civils de Lyon and Lyon's Neurosciences Research Center, INSERM U1028/CNRS UMR5292/Lyon 1 University, Lyon, France
| | - Rodrigo Rocamora
- Epilepsy Monitoring Unit, Department of Neurology, Hospital del Mar-IMIM, Barcelona, Spain
| | - Andreas Schulze-Bonhage
- Epilepsy Center, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - William Szurhaj
- Epilepsy Unit, Department of Clinical Neurophysiology, Lille University Medical Center, Lille, France
| | - Delphine Taussig
- Neurophysiology and Epilepsy Unit, Bicêtre Hospital, France.,Service de Neurochirurgie Pédiatrique, Fondation Rothschild, Paris, France
| | - Antonio Valentin
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), London, UK
| | - Haixiang Wang
- Yuquan Hospital Epilepsy Center, Tsinghua University, Beijing, China
| | - Philippe Kahane
- Université Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France.,Neurology Department, CHU Grenoble Alpes, Grenoble, France
| | - Nathalie George
- Sorbonne Université, Institut du Cerveau-Paris Brain Institute-ICM, Inserm, CNRS, Centre MEG-EEG and Experimental Neurosurgery Team, F-75013 Paris, France
| | - Olivier David
- Université Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France.,Aix Marseille Université, Inserm, INS, Institut de Neurosciences des Systèmes, Marseille, France
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15
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Hays MA, Smith RJ, Haridas B, Coogan C, Crone NE, Kang JY. Effects of stimulation intensity on intracranial cortico-cortical evoked potentials: A titration study. Clin Neurophysiol 2021; 132:2766-2777. [PMID: 34583119 DOI: 10.1016/j.clinph.2021.08.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 07/26/2021] [Accepted: 08/04/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The aim of the present study was to investigate the optimal stimulation parameters for eliciting cortico-cortical evoked potentials (CCEPs) for mapping functional and epileptogenic networks. METHODS We studied 13 patients with refractory epilepsy undergoing intracranial EEG monitoring. We systematically titrated the intensity of single-pulse electrical stimulation at multiple sites to assess the effect of increasing current on salient features of CCEPs such as N1 potential magnitude, signal to noise ratio, waveform similarity, and spatial distribution of responses. Responses at each incremental stimulation setting were compared to each other and to a final set of responses at the maximum intensity used in each patient (3.5-10 mA, median 6 mA). RESULTS We found that with a biphasic 0.15 ms/phase pulse at least 2-4 mA is needed to differentiate between non-responsive and responsive sites, and that stimulation currents of 6-7 mA are needed to maximize amplitude and spatial distribution of N1 responses and stabilize waveform morphology. CONCLUSIONS We determined a minimum stimulation threshold necessary for eliciting CCEPs, as well as a point at which the current-dependent relationship of several response metrics all saturate. SIGNIFICANCE This titration study provides practical, immediate guidance on optimal stimulation parameters to study specific features of CCEPs, which have been increasingly used to map both functional and epileptic brain networks in humans.
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Affiliation(s)
- Mark A Hays
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Rachel J Smith
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Babitha Haridas
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Christopher Coogan
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Nathan E Crone
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Joon Y Kang
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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16
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Aron O, Jonas J, Colnat-Coulbois S, Maillard L. Language Mapping Using Stereo Electroencephalography: A Review and Expert Opinion. Front Hum Neurosci 2021; 15:619521. [PMID: 33776668 PMCID: PMC7987679 DOI: 10.3389/fnhum.2021.619521] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 02/11/2021] [Indexed: 11/25/2022] Open
Abstract
Stereo-electroencephalography (sEEG) is a method that uses stereotactically implanted depth electrodes for extra-operative mapping of epileptogenic and functional networks. sEEG derived functional mapping is achieved using electrical cortical stimulations (ECS) that are currently the gold standard for delineating eloquent cortex. As this stands true especially for primary cortices (e.g., visual, sensitive, motor, etc.), ECS applied to higher order brain areas determine more subtle behavioral responses. While anterior and posterior language areas in the dorsal language stream seem to share characteristics with primary cortices, basal temporal language area (BTLA) in the ventral temporal cortex (VTC) behaves as a highly associative cortex. After a short introduction and considerations about methodological aspects of ECS using sEEG, we review the sEEG language mapping literature in this perspective. We first establish the validity of this technique to map indispensable language cortices in the dorsal language stream. Second, we highlight the contrast between the growing empirical ECS experience and the lack of understanding regarding the fundamental mechanisms underlying ECS behavioral effects, especially concerning the dispensable language cortex in the VTC. Evidences for considering network architecture as determinant for ECS behavioral response complexities are discussed. Further, we address the importance of designing new research in network organization of language as this could enhance ECS ability to map interindividual variability, pathology driven reorganization, and ultimately identify network resilience markers in order to better predict post-operative language deficit. Finally, based on a whole body of available studies, we believe there is strong evidence to consider sEEG as a valid, safe and reliable method for defining eloquent language cortices although there have been no proper comparisons between surgical resections with or without extra-operative or intra-operative language mapping.
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Affiliation(s)
- Olivier Aron
- Department of Neurology, Nancy University Hospital Center, Nancy, France
- CRAN, Université́ de Lorraine, CNRS, Nancy, France
| | - Jacques Jonas
- Department of Neurology, Nancy University Hospital Center, Nancy, France
- CRAN, Université́ de Lorraine, CNRS, Nancy, France
| | | | - Louis Maillard
- Department of Neurology, Nancy University Hospital Center, Nancy, France
- CRAN, Université́ de Lorraine, CNRS, Nancy, France
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17
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Barborica A, Mindruta I, Sheybani L, Spinelli L, Oane I, Pistol C, Donos C, López-Madrona VJ, Vulliemoz S, Bénar CG. Extracting seizure onset from surface EEG with independent component analysis: Insights from simultaneous scalp and intracerebral EEG. NEUROIMAGE: CLINICAL 2021; 32:102838. [PMID: 34624636 PMCID: PMC8503578 DOI: 10.1016/j.nicl.2021.102838] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 09/16/2021] [Accepted: 09/20/2021] [Indexed: 11/01/2022] Open
Abstract
Independent component analysis (ICA) is able to identify seizure generators. Simultaneous long-term scalp-SEEG allows validation of the ICA results. Ability to record seizure onset patterns on scalp depends on generator depth.
The success of stereoelectroencephalographic (SEEG) investigations depends crucially on the hypotheses on the putative location of the seizure onset zone. This information is derived from non-invasive data either based on visual analysis or advanced source localization algorithms. While source localization applied to interictal spikes recorded on scalp is the classical method, it does not provide unequivocal information regarding the seizure onset zone. Raw ictal activity contains a mixture of signals originating from several regions of the brain as well as EMG artifacts, hampering direct input to the source localization algorithms. We therefore introduce a methodology that disentangles the various sources contributing to the scalp ictal activity using independent component analysis and uses equivalent current dipole localization as putative locus of ictal sources. We validated the results of our analysis pipeline by performing long-term simultaneous scalp – intracerebral (SEEG) recordings in 14 patients and analyzing the wavelet coherence between the independent component encoding the ictal discharge and the SEEG signals in 8 patients passing the inclusion criteria. Our results show that invasively recorded ictal onset patterns, including low-voltage fast activity, can be captured by the independent component analysis of scalp EEG. The visibility of the ictal activity strongly depends on the depth of the sources. The equivalent current dipole localization can point to the seizure onset zone (SOZ) with an accuracy that can be as high as 10 mm for superficially located sources, that gradually decreases for deeper seizure generators, averaging at 47 mm in the 8 analyzed patients. Independent component analysis is therefore shown to have a promising SOZ localizing value, indicating whether the seizure onset zone is neocortical, and its approximate location, or located in mesial structures. That may contribute to a better crafting of the hypotheses used as basis of the stereo-EEG implantations.
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Trebuchon A, Racila R, Cardinale F, Lagarde S, McGonigal A, Lo Russo G, Scavarda D, Carron R, Mai R, Chauvel P, Bartolomei F, Francione S. Electrical stimulation for seizure induction during SEEG exploration: a useful predictor of postoperative seizure recurrence? J Neurol Neurosurg Psychiatry 2020; 92:jnnp-2019-322469. [PMID: 33115935 DOI: 10.1136/jnnp-2019-322469] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 07/22/2020] [Accepted: 08/31/2020] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Direct electrical stimulations of cerebral cortex are a traditional part of stereoelectroencephalography (SEEG) practice, but their value as a predictive factor for seizure outcome has never been carefully investigated. PATIENTS AND METHOD We retrospectively analysed a cohort of 346 patients operated on for drug-resistant focal epilepsy after SEEG exploration. As potential predictors we included: aetiology, MRI data, age of onset, duration of epilepsy, age at surgery, topography of surgery and whether a seizure was induced by either low frequency electrical stimulation (LFS) or high frequency electrical stimulation. RESULTS Of 346 patients, 63.6% had good outcome (no seizure recurrence, Engel I). Univariate analysis demonstrated significant correlation with favourable outcome (Engel I) for: aetiology, positive MRI and seizure induced by stimulation. At multivariate analysis, informative MRI, type II focal cortical dysplasia and tumour reduced the risk of seizure recurrence (SR) by 47%, 58% and 81%, respectively. Compared with the absence of induced seizures, the occurrence of ictal events after LFS significantly predicts a favourable outcome on seizures, with only 44% chance of disabling SR at last follow-up. CONCLUSION Among the already known predictors outcome, seizure induction by LFS therefore represents a positive predictive factor for seizure outcome after surgery.
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Affiliation(s)
- Agnes Trebuchon
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France
- Epileptology and Clinical Neurophysiology, AP-HM, Timone Hospital, Marseille, France
| | - Renata Racila
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France
| | - Francesco Cardinale
- Epilepsy and Parkinson Surgery Centre "C. Munari", Ospedale Niguarda Ca' Granda, Milan, Italy
| | - Stanislas Lagarde
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France
- Epileptology and Clinical Neurophysiology, AP-HM, Timone Hospital, Marseille, France
| | - Aileen McGonigal
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France
- Epileptology and Clinical Neurophysiology, AP-HM, Timone Hospital, Marseille, France
| | - Giorgio Lo Russo
- Epilepsy and Parkinson Surgery Centre "C. Munari", Ospedale Niguarda Ca' Granda, Milan, Italy
| | - Didier Scavarda
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France
- Peadiatric Neurosurgery Unit, AP-HM, Timone Hospital, Marseille, France
| | - Romain Carron
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France
- Functional Neurosurgery Unit, AP-HM, Timone Hospital, Marseille, France
| | - Roberto Mai
- Epilepsy and Parkinson Surgery Centre "C. Munari", Ospedale Niguarda Ca' Granda, Milan, Italy
| | - Patrick Chauvel
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France
| | - Fabrice Bartolomei
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France
- Epileptology and Clinical Neurophysiology, AP-HM, Timone Hospital, Marseille, France
| | - Stefano Francione
- Epilepsy and Parkinson Surgery Centre "C. Munari", Ospedale Niguarda Ca' Granda, Milan, Italy
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Kundu B, Davis TS, Philip B, Smith EH, Arain A, Peters A, Newman B, Butson CR, Rolston JD. A systematic exploration of parameters affecting evoked intracranial potentials in patients with epilepsy. Brain Stimul 2020; 13:1232-1244. [PMID: 32504827 PMCID: PMC7494632 DOI: 10.1016/j.brs.2020.06.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 05/27/2020] [Accepted: 06/01/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Brain activity is constrained by and evolves over a network of structural and functional connections. Corticocortical evoked potentials (CCEPs) have been used to measure this connectivity and to discern brain areas involved in both brain function and disease. However, how varying stimulation parameters influences the measured CCEP across brain areas has not been well characterized. OBJECTIVE To better understand the factors that influence the amplitude of the CCEPs as well as evoked gamma-band power (70-150 Hz) resulting from single-pulse stimulation via cortical surface and depth electrodes. METHODS CCEPs from 4370 stimulation-response channel pairs were recorded across a range of stimulation parameters and brain regions in 11 patients undergoing long-term monitoring for epilepsy. A generalized mixed-effects model was used to model cortical response amplitudes from 5 to 100 ms post-stimulation. RESULTS Stimulation levels <5.5 mA generated variable CCEPs with low amplitude and reduced spatial spread. Stimulation at ≥5.5 mA yielded a reliable and maximal CCEP across stimulation-response pairs over all regions. These findings were similar when examining the evoked gamma-band power. The amplitude of both measures was inversely correlated with distance. CCEPs and evoked gamma power were largest when measured in the hippocampus compared with other areas. Larger CCEP size and evoked gamma power were measured within the seizure onset zone compared with outside this zone. CONCLUSION These results will help guide future stimulation protocols directed at quantifying network connectivity across cognitive and disease states.
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Affiliation(s)
- Bornali Kundu
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, UT, USA
| | - Tyler S Davis
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, UT, USA
| | - Brian Philip
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, USA
| | - Elliot H Smith
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, UT, USA
| | - Amir Arain
- Department of Neurology, Clinical Neurosciences Center, University of Utah, Salt Lake City, UT, USA
| | - Angela Peters
- Department of Neurology, Clinical Neurosciences Center, University of Utah, Salt Lake City, UT, USA
| | - Blake Newman
- Department of Neurology, Clinical Neurosciences Center, University of Utah, Salt Lake City, UT, USA
| | - Christopher R Butson
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, UT, USA; Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, USA; Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT, USA
| | - John D Rolston
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, UT, USA; Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, USA; Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT, USA.
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Oane I, Barborica A, Chetan F, Donos C, Maliia MD, Arbune AA, Daneasa A, Pistol C, Nica AE, Bajenaru OA, Mindruta I. Cingulate cortex function and multi-modal connectivity mapped using intracranial stimulation. Neuroimage 2020; 220:117059. [PMID: 32562780 DOI: 10.1016/j.neuroimage.2020.117059] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 05/19/2020] [Accepted: 06/12/2020] [Indexed: 12/12/2022] Open
Abstract
The cingulate cortex is part of the limbic system. Its function and connectivity are organized in a rostro-caudal and ventral-dorsal manner which was addressed by various other studies using rather coarse cortical parcellations. In this study, we aim at describing its function and connectivity using invasive recordings from patients explored for focal drug-resistant epilepsy. We included patients that underwent stereo-electroencephalographic recordings using intracranial electrodes in the University Emergency Hospital Bucharest between 2012 and 2019. We reviewed all high frequency stimulations (50 Hz) performed for functional mapping of the cingulate cortex. We used two methods to characterize brain connectivity. Effective connectivity was inferred based on the analysis of cortico-cortical potentials (CCEPs) evoked by single pulse electrical stimulation (SPES) (15 s inter-pulse interval). Functional connectivity was estimated using the non-linear regression method applied to 60 s spontaneous electrical brain signal intervals. The effective (stimulation-evoked) and functional (non-evoked) connectivity analyses highlight brain networks in a different way. While non-evoked connectivity evidences areas having related activity, often in close proximity to each other, evoked connectivity highlights spatially extended networks. To highlight in a comprehensive way the cingulate cortex's network, we have performed a bi-modal connectivity analysis that combines the resting-state broadband h2 non-linear correlation with cortico-cortical evoked potentials. We co-registered the patient's anatomy with the fsaverage FreeSurfer template to perform the automatic labeling based on HCP-MMP parcellation. At a group level, connectivity was estimated by averaging responses over stimulated/recorded or recorded sites in each pair of parcels. Finally, for multiple regions that evoked a clinical response during high frequency stimulation, we combined the connectivity of individual pairs using maximum intensity projection. Connectivity was assessed by applying SPES on 2094 contact pairs and recording CCEPs on 3580 contacts out of 8582 contacts of 660 electrodes implanted in 47 patients. Clinical responses elicited by high frequency stimulations in 107 sites (pairs of contacts) located in the cingulate cortex were divided in 10 groups: affective, motor behavior, motor elementary, versive, speech, vestibular, autonomic, somatosensory, visual and changes in body perception. Anterior cingulate cortex was shown to be connected to the mesial temporal, orbitofrontal and prefrontal cortex. In the middle cingulate cortex, we located affective, motor behavior in the anterior region, and elementary motor and somatosensory in the posterior part. This region is connected to the prefrontal, premotor and primary motor network. Finally, the posterior cingulate was shown to be connected with the visual areas, mesial and lateral parietal and temporal cortex.
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Affiliation(s)
- Irina Oane
- Epilepsy Monitoring Unit, Neurology Department, Emergency University Hospital Bucharest, 169 Splaiul Independentei Street, Bucharest, Romania; Neurology Department, Medical Faculty, Carol Davila University of Medicine and Pharmacy Bucharest, 8 Eroii Sanitari Boulevard 8, Bucharest, Romania.
| | - Andrei Barborica
- Physics Department, University of Bucharest, 405 Atomistilor Street, Bucharest, Romania.
| | - Filip Chetan
- Epilepsy Monitoring Unit, Neurology Department, Emergency University Hospital Bucharest, 169 Splaiul Independentei Street, Bucharest, Romania.
| | - Cristian Donos
- Physics Department, University of Bucharest, 405 Atomistilor Street, Bucharest, Romania.
| | - Mihai Dragos Maliia
- Epilepsy Monitoring Unit, Neurology Department, Emergency University Hospital Bucharest, 169 Splaiul Independentei Street, Bucharest, Romania; Physics Department, University of Bucharest, 405 Atomistilor Street, Bucharest, Romania.
| | - Anca Adriana Arbune
- Epilepsy Monitoring Unit, Neurology Department, Emergency University Hospital Bucharest, 169 Splaiul Independentei Street, Bucharest, Romania; Neurology Department, Medical Faculty, Carol Davila University of Medicine and Pharmacy Bucharest, 8 Eroii Sanitari Boulevard 8, Bucharest, Romania.
| | - Andrei Daneasa
- Epilepsy Monitoring Unit, Neurology Department, Emergency University Hospital Bucharest, 169 Splaiul Independentei Street, Bucharest, Romania.
| | - Constantin Pistol
- Physics Department, University of Bucharest, 405 Atomistilor Street, Bucharest, Romania.
| | - Adriana Elena Nica
- Intensive Care Unit Department, Emergency University Hospital Bucharest, 169 Splaiul Independentei Street, Bucharest, Romania.
| | - Ovidiu Alexandru Bajenaru
- Epilepsy Monitoring Unit, Neurology Department, Emergency University Hospital Bucharest, 169 Splaiul Independentei Street, Bucharest, Romania; Neurology Department, Medical Faculty, Carol Davila University of Medicine and Pharmacy Bucharest, 8 Eroii Sanitari Boulevard 8, Bucharest, Romania; Brain Research Group, Romanian Academy, 125 Calea Victoriei Street, Bucharest, Romania.
| | - Ioana Mindruta
- Epilepsy Monitoring Unit, Neurology Department, Emergency University Hospital Bucharest, 169 Splaiul Independentei Street, Bucharest, Romania; Neurology Department, Medical Faculty, Carol Davila University of Medicine and Pharmacy Bucharest, 8 Eroii Sanitari Boulevard 8, Bucharest, Romania; Brain Research Group, Romanian Academy, 125 Calea Victoriei Street, Bucharest, Romania.
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George DD, Ojemann SG, Drees C, Thompson JA. Stimulation Mapping Using Stereoelectroencephalography: Current and Future Directions. Front Neurol 2020; 11:320. [PMID: 32477236 PMCID: PMC7238877 DOI: 10.3389/fneur.2020.00320] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Accepted: 04/02/2020] [Indexed: 01/06/2023] Open
Abstract
Electrical stimulation mapping (ESM) using stereoelectroencephalography (SEEG) is an essential component in the workup of surgical epilepsy. Since the initial application of ESM in the mid-1960s, it remains unparalleled in defining eloquent brain areas and delimiting seizure foci for the purposes of surgical planning. Here, we briefly review the current state of SEEG stimulation, with a focus on the techniques used for identifying the epileptogenic zone and eloquent cortex. We also summarize clinical data on the efficacy of SEEG stimulation in surgical outcomes and functional mapping. Finally, we briefly highlight future applications of SEEG ESM, including novel functional mapping approaches, identifying rare seizure semiologies, neurophysiologic investigations for understanding cognitive function, and its role in SEEG-guided radiofrequency thermal coagulation.
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Affiliation(s)
- Derek D George
- School of Medicine, University of Colorado School of Medicine, Aurora, CO, United States
| | - Steven G Ojemann
- Department of Neurosurgery, University of Colorado School of Medicine, Aurora, CO, United States
| | - Cornelia Drees
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO, United States
| | - John A Thompson
- Department of Neurosurgery, University of Colorado School of Medicine, Aurora, CO, United States.,Department of Neurology, University of Colorado School of Medicine, Aurora, CO, United States
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22
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Novitskaya Y, Dümpelmann M, Vlachos A, Reinacher PC, Schulze-Bonhage A. In vivo-assessment of the human temporal network: Evidence for asymmetrical effective connectivity. Neuroimage 2020; 214:116769. [PMID: 32217164 DOI: 10.1016/j.neuroimage.2020.116769] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 02/22/2020] [Accepted: 03/19/2020] [Indexed: 11/16/2022] Open
Abstract
The human temporal lobe is a multimodal association area which plays a key role in various aspects of cognition, particularly in memory formation and spatial navigation. Functional and anatomical connectivity of temporal structures is thus a subject of intense research, yet by far underexplored in humans due to ethical and technical limitations. We assessed intratemporal cortico-cortical interactions in the living human brain by means of single pulse electrical stimulation, an invasive method allowing mapping effective intracortical connectivity with a high spatiotemporal resolution. Eighteen subjects with normal anterior-mesial temporal MR imaging undergoing intracranial presurgical epilepsy diagnostics with multiple depth electrodes were included. The investigated structures were temporal pole, hippocampus, amygdala and parahippocampal gyrus. Intratemporal cortical connectivity was assessed as a function of amplitude of the early component of the cortico-cortical evoked potentials (CCEP). While the analysis revealed robust interconnectivity between all explored structures, a clear asymmetry in bidirectional connectivity was detected for the hippocampal network and for the connections between the temporal pole and parahippocampal gyrus. The amygdala showed bidirectional asymmetry only to the hippocampus. The provided evidence of asymmetrically weighed intratemporal effective connectivity in humans in vivo is important for understanding of functional interactions within the temporal lobe since asymmetries in the brain connectivity define hierarchies in information processing. The findings are in exact accord with the anatomical tracing studies in non-human primates and open a translational route for interventions employing modulation of temporal lobe function.
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Affiliation(s)
- Yulia Novitskaya
- Epilepsy Center, Department of Neurosurgery, Faculty of Medicine, University of Freiburg, Breisacher Strasse 64, 79106, Freiburg, Germany.
| | - Matthias Dümpelmann
- Epilepsy Center, Department of Neurosurgery, Faculty of Medicine, University of Freiburg, Breisacher Strasse 64, 79106, Freiburg, Germany
| | - Andreas Vlachos
- Department of Neuroanatomy, Institute of Anatomy and Cell Biology, Faculty of Medicine, University of Freiburg, Albert Strasse 17, 79104, Freiburg, Germany; Center for Basics in NeuroModulation, Faculty of Medicine, University of Freiburg, Breisacher Strasse 64, 79106, Freiburg, Germany
| | - Peter Christoph Reinacher
- Department of Stereotactic and Functional Neurosurgery, Faculty of Medicine, University of Freiburg, Breisacher Strasse 64, 79106, Freiburg, Germany
| | - Andreas Schulze-Bonhage
- Epilepsy Center, Department of Neurosurgery, Faculty of Medicine, University of Freiburg, Breisacher Strasse 64, 79106, Freiburg, Germany; Center for Basics in NeuroModulation, Faculty of Medicine, University of Freiburg, Breisacher Strasse 64, 79106, Freiburg, Germany
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Prime D, Woolfe M, O'Keefe S, Rowlands D, Dionisio S. Quantifying volume conducted potential using stimulation artefact in cortico-cortical evoked potentials. J Neurosci Methods 2020; 337:108639. [PMID: 32156547 DOI: 10.1016/j.jneumeth.2020.108639] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 02/16/2020] [Accepted: 02/18/2020] [Indexed: 01/27/2023]
Abstract
BACKGROUND Cortico-cortical evoked potentials (CCEP) are a technique using low frequency stimulation to infer regions of cortical connectivity in patients undergoing Stereo-electroencephalographic (SEEG) monitoring for refractory epilepsy. Little attention has been given to volume conducted components of CCEP responses, and how they may inflate CCEP connectivity. NEW METHOD Using data from 37 SEEG-CCEPs patients, a novel method was developed to quantify stimulation artefact by measuring the peak-to-peak voltage difference in the first 10 ms after CCEP stimulation. Early responses to CCEP stimulation were also quantified by calculating the root mean square of the 10-100 ms period after each stimulation pulse. Both the early CCEP responses and amplitude of stimulation artefact were regressed by physical distance, stimulation waveform, stimulation intensity and tissue type to identify conduction related properties. RESULTS Both stimulation artefact and early responses were correlated strongly with the inverse square of the distance from the stimulating electrode. Once corrected for the inverse square distance from the electrode, stimulation artefact and CCEP responses showed a linear relationship, indicating a volume conducted component. COMPARISON WITH EXISTING METHODS This is the first study to use stimulation artefact to quantify volume conducted potentials, and is the first to quantify volume conducted potentials in SEEG. A single prior study utilizing electrocorticography has shown that parts of early CCEP responses are due to volume conduction. CONCLUSIONS The linear relationship between stimulation artefact amplitude and CCEP early responses, once corrected for distance, suggests that stimulation artefact can be used as a measure to quantify the volume conducted components.
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Affiliation(s)
- David Prime
- Griffith University School of Engineering, Nathan, QLD, Australia; Mater Advanced Epilepsy Unit, Brisbane, QLD, Australia.
| | - Matthew Woolfe
- Griffith University School of Engineering, Nathan, QLD, Australia; Mater Advanced Epilepsy Unit, Brisbane, QLD, Australia
| | - Steven O'Keefe
- Griffith University School of Engineering, Nathan, QLD, Australia
| | - David Rowlands
- Griffith University School of Engineering, Nathan, QLD, Australia
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Prime D, Woolfe M, Rowlands D, O'Keefe S, Dionisio S. Comparing connectivity metrics in cortico-cortical evoked potentials using synthetic cortical response patterns. J Neurosci Methods 2020; 334:108559. [PMID: 31927000 DOI: 10.1016/j.jneumeth.2019.108559] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 12/06/2019] [Accepted: 12/16/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Cortico-Cortical Evoked Potentials (CCEPs) are a novel low frequency stimulation method used for brain mapping during intracranial epilepsy investigations. Only a handful of metrics have been applied to CCEP data to infer connectivity, and no comparison as to which is best has been performed. NEW METHOD We implement a novel method which involved superimposing synthetic cortical responses onto stereoelectroencephalographic (SEEG) data, and use this to compare several metric's ability to detect the simulated patterns. In this we compare two commonly employed metrics currently used in CCEP analysis against eight time series similarity metrics (TSSMs), which have been widely used in machine learning and pattern matching applications. RESULTS Root Mean Square (RMS), a metric commonly employed in CCEP analysis, was sensitive to a wide variety of response patterns, but insensitive to simulated epileptiform patterns. Autoregressive (AR) coefficients calculated by Burg's method were also sensitive to a wide range of patterns, but were extremely sensitive to epileptiform patterns. Other metrics which employed elastic warping techniques were less sensitive to the simulated response patterns. COMPARISON WITH EXISTING METHODS Our study is the first to compare CCEP connectivity metrics against one-another. Our results found that RMS, which has been used in many CCEP studies previously, was the most sensitive metric across a wide range of patterns. CONCLUSIONS Our novel method showed that RMS is a robust and sensitive measure, validating much of the findings of the SEEG-CCEP literature to date. Autoregressive coefficients may also be a useful metric to investigate epileptic networks.
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Affiliation(s)
- David Prime
- Griffith University School of Engineering and Built Environment, Nathan, QLD, Australia; Mater Advanced Epilepsy Unit, Brisbane, QLD, Australia.
| | - Matthew Woolfe
- Griffith University School of Engineering and Built Environment, Nathan, QLD, Australia; Mater Advanced Epilepsy Unit, Brisbane, QLD, Australia
| | - David Rowlands
- Griffith University School of Engineering and Built Environment, Nathan, QLD, Australia
| | - Steven O'Keefe
- Griffith University School of Engineering and Built Environment, Nathan, QLD, Australia
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Sleep modulates effective connectivity: A study using intracranial stimulation and recording. Clin Neurophysiol 2019; 131:529-541. [PMID: 31708382 DOI: 10.1016/j.clinph.2019.09.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 08/30/2019] [Accepted: 09/03/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Sleep is an active process with an important role in memory. Epilepsy patients often display a disturbed sleep architecture, with consequences on cognition. We aimed to investigate the effect of sleep on cortical networks' organization. METHODS We analyzed cortico-cortical evoked responses elicited by single pulse electrical stimulation (SPES) using intracranial depth electrodes in 25 patients with drug-resistant focal epilepsy explored using stereo-EEG. We applied the SPES protocol during wakefulness and NREM - N2 sleep. We analyzed 31,710 significant responses elicited by 799 stimulations covering most brain structures, epileptogenic or non-epileptogenic. We analyzed effective connectivity between structures using a graph-theory approach. RESULTS Sleep increases excitability in the brain, regardless of epileptogenicity. Local and distant connections are differently modulated by sleep, depending on the tissue epileptogenicity. In non-epileptogenic areas, frontal lobe connectivity is enhanced during sleep. There is increased connectivity between the hippocampus and temporal neocortex, while perisylvian structures are disconnected from the temporal lobe. In epileptogenic areas, we found a clear interhemispheric difference, with decreased connectivity in the right hemisphere during sleep. CONCLUSIONS Sleep modulates brain excitability and reconfigures functional brain networks, depending on tissue epileptogenicity. SIGNIFICANCE We found specific patterns of information flow during sleep in physiologic and pathologic structures, with possible implications for cognition.
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File B, Nánási T, Tóth E, Bokodi V, Tóth B, Hajnal B, Kardos Z, Entz L, Erőss L, Ulbert I, Fabó D. Reorganization of Large-Scale Functional Networks During Low-Frequency Electrical Stimulation of the Cortical Surface. Int J Neural Syst 2019; 30:1950022. [DOI: 10.1142/s0129065719500229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We investigated the functional network reorganization caused by low-frequency electrical stimulation (LFES) of human brain cortical surface. Intracranial EEG data from subdural grid positions were analyzed in 16 pre-surgery epileptic patients. LFES was performed by injecting current pulses (10[Formula: see text]mA, 0.2[Formula: see text]ms pulse width, 0.5[Formula: see text]Hz, 25 trials) into all adjacent electrode contacts. Dynamic functional connectivity analysis was carried out on two frequency bands (low: 1–4[Formula: see text]Hz; high: 10–40[Formula: see text]Hz) to investigate the early, high frequency and late, low frequency responses elicited by the stimulation. The centralization increased in early compared to late responses, suggesting a more prominent role of direct neural links between primarily activated areas and distant brain regions. Injecting the current into the seizure onset zone (SOZ) evoked a more integrated functional topology during the early (N1) period of the response, whereas during the late (N2) period — regardless of the stimulation site — the connectedness of the SOZ was elevated compared to the non-SOZ tissue. The abnormal behavior of the epileptic sub-network during both part of the responses supports the idea of the pathogenic role of impaired inhibition and excitation mechanisms in epilepsy.
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Affiliation(s)
- Bálint File
- Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Budapest, H-1083, Hungary
- Computational Neuroscience Group, Wigner Research Centre for Physics, HAS, Budapest, H-1121, Hungary
| | - Tibor Nánási
- Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Budapest, H-1083, Hungary
- Institute of Cognitive Neuroscience and Psychology, RCNS, HAS, Budapest, H-1117, Hungary
- János Szentágothai Doctoral School of Neurosciences, Semmelweis University, Budapest, H-1085, Hungary
| | - Emília Tóth
- Department of Neurology, University of Alabama at Birmingham, AL 35233, USA
| | - Virág Bokodi
- Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Budapest, H-1083, Hungary
- Department of Functional Neurosurgery, National Institute of Clinical Neurosciences, Budapest, H-1145, Hungary
| | - Brigitta Tóth
- Institute of Cognitive Neuroscience and Psychology, RCNS, HAS, Budapest, H-1117, Hungary
| | - Boglárka Hajnal
- Juhász Pál Epilepsy Centrum, National Institute of Clinical Neuroscience, Budapest, H-1145, Hungary
| | - Zsófia Kardos
- Institute of Cognitive Neuroscience and Psychology, RCNS, HAS, Budapest, H-1117, Hungary
| | - László Entz
- Department of Functional Neurosurgery, National Institute of Clinical Neurosciences, Budapest, H-1145, Hungary
| | - Loránd Erőss
- Department of Functional Neurosurgery, National Institute of Clinical Neurosciences, Budapest, H-1145, Hungary
| | - István Ulbert
- Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Budapest, H-1083, Hungary
- Institute of Cognitive Neuroscience and Psychology, RCNS, HAS, Budapest, H-1117, Hungary
| | - Dániel Fabó
- Juhász Pál Epilepsy Centrum, National Institute of Clinical Neuroscience, Budapest, H-1145, Hungary
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Hebbink J, Huiskamp G, van Gils SA, Leijten FSS, Meijer HGE. Pathological responses to single-pulse electrical stimuli in epilepsy: The role of feedforward inhibition. Eur J Neurosci 2019; 51:1122-1136. [PMID: 31454445 PMCID: PMC7079068 DOI: 10.1111/ejn.14562] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 08/11/2019] [Accepted: 08/15/2019] [Indexed: 11/30/2022]
Abstract
Delineation of epileptogenic cortex in focal epilepsy patients may profit from single‐pulse electrical stimulation during intracranial EEG recordings. Single‐pulse electrical stimulation evokes early and delayed responses. Early responses represent connectivity. Delayed responses are a biomarker for epileptogenic cortex, but up till now, the precise mechanism generating delayed responses remains elusive. We used a data‐driven modelling approach to study early and delayed responses. We hypothesized that delayed responses represent indirect responses triggered by early response activity and investigated this for 11 patients. Using two coupled neural masses, we modelled early and delayed responses by combining simulations and bifurcation analysis. An important feature of the model is the inclusion of feedforward inhibitory connections. The waveform of early responses can be explained by feedforward inhibition. Delayed responses can be viewed as second‐order responses in the early response network which appear when input to a neural mass falls below a threshold forcing it temporarily to a spiking state. The combination of the threshold with noisy background input explains the typical stochastic appearance of delayed responses. The intrinsic excitability of a neural mass and the strength of its input influence the probability at which delayed responses to occur. Our work gives a theoretical basis for the use of delayed responses as a biomarker for the epileptogenic zone, confirming earlier clinical observations. The combination of early responses revealing effective connectivity, and delayed responses showing intrinsic excitability, makes single‐pulse electrical stimulation an interesting tool to obtain data for computational models of epilepsy surgery.
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Affiliation(s)
- Jurgen Hebbink
- Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Centre Utrecht, Utrecht, The Netherlands.,Department of Applied Mathematics and Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - Geertjan Huiskamp
- Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Stephan A van Gils
- Department of Applied Mathematics and Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - Frans S S Leijten
- Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Hil G E Meijer
- Department of Applied Mathematics and Technical Medical Centre, University of Twente, Enschede, The Netherlands
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28
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Basu I, Robertson MM, Crocker B, Peled N, Farnes K, Vallejo-Lopez DI, Deng H, Thombs M, Martinez-Rubio C, Cheng JJ, McDonald E, Dougherty DD, Eskandar EN, Widge AS, Paulk AC, Cash SS. Consistent linear and non-linear responses to invasive electrical brain stimulation across individuals and primate species with implanted electrodes. Brain Stimul 2019; 12:877-892. [PMID: 30904423 PMCID: PMC6752738 DOI: 10.1016/j.brs.2019.03.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 03/05/2019] [Accepted: 03/06/2019] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Electrical neuromodulation via implanted electrodes is used in treating numerous neurological disorders, yet our knowledge of how different brain regions respond to varying stimulation parameters is sparse. OBJECTIVE/HYPOTHESIS We hypothesized that the neural response to electrical stimulation is both region-specific and non-linearly related to amplitude and frequency. METHODS We examined evoked neural responses following 400 ms trains of 10-400 Hz electrical stimulation ranging from 0.1 to 10 mA. We stimulated electrodes implanted in cingulate cortex (dorsal anterior cingulate and rostral anterior cingulate) and subcortical regions (nucleus accumbens, amygdala) of non-human primates (NHP, N = 4) and patients with intractable epilepsy (N = 15) being monitored via intracranial electrodes. Recordings were performed in prefrontal, subcortical, and temporal lobe locations. RESULTS In subcortical regions as well as dorsal and rostral anterior cingulate cortex, response waveforms depended non-linearly on frequency (Pearson's linear correlation r < 0.39), but linearly on current (r > 0.58). These relationships between location, and input-output characteristics were similar in homologous brain regions with average Pearson's linear correlation values r > 0.75 between species and linear correlation values between participants r > 0.75 across frequency and current values per brain region. Evoked waveforms could be described by three main principal components (PCs) which allowed us to successfully predict response waveforms across individuals and across frequencies using PC strengths as functions of current and frequency using brain region specific regression models. CONCLUSIONS These results provide a framework for creation of an atlas of input-output relationships which could be used in the principled selection of stimulation parameters per brain region.
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Affiliation(s)
- Ishita Basu
- Nayef Al-Rodhan Laboratories, Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, 02129, USA
| | - Madeline M Robertson
- Nayef Al-Rodhan Laboratories, Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Britni Crocker
- Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Noam Peled
- Department of Radiology, MGH/HST Martinos Center for Biomedical Imaging, Charlestown, MA, 02129, USA
| | - Kara Farnes
- Nayef Al-Rodhan Laboratories, Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA
| | | | - Helen Deng
- Nayef Al-Rodhan Laboratories, Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; Department of Radiology, MGH/HST Martinos Center for Biomedical Imaging, Charlestown, MA, 02129, USA
| | - Matthew Thombs
- Nayef Al-Rodhan Laboratories, Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Clarissa Martinez-Rubio
- Nayef Al-Rodhan Laboratories, Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Jennifer J Cheng
- Nayef Al-Rodhan Laboratories, Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Eric McDonald
- Nayef Al-Rodhan Laboratories, Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Darin D Dougherty
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, 02129, USA
| | - Emad N Eskandar
- Nayef Al-Rodhan Laboratories, Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Alik S Widge
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, 02129, USA; Picower Institute for Learning & Memory, Massachusetts Institute of Technology, Cambridge, MA 02124, USA
| | - Angelique C Paulk
- Nayef Al-Rodhan Laboratories, Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA.
| | - Sydney S Cash
- Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA
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29
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Popa I, Barborica A, Scholly J, Donos C, Bartolomei F, Lagarde S, Hirsch E, Valenti‐Hirsch M, Maliia MD, Arbune AA, Daneasa A, Ciurea J, Bajenaru O, Mindruta I. Illusory own body perceptions mapped in the cingulate cortex-An intracranial stimulation study. Hum Brain Mapp 2019; 40:2813-2826. [PMID: 30868705 PMCID: PMC6865384 DOI: 10.1002/hbm.24563] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 02/18/2019] [Accepted: 02/19/2019] [Indexed: 11/07/2022] Open
Abstract
Body awareness is the result of sensory integration in the posterior parietal cortex; however, other brain structures are part of this process. Our goal is to determine how the cingulate cortex is involved in the representation of our body. We retrospectively selected patients with drug-resistant epilepsy, explored by stereo-electroencephalography, that had the cingulate cortex sampled outside the epileptogenic zone. The clinical effects of high-frequency electrical stimulation were reviewed and only those sites that elicited changes related to body perception were included. Connectivity of the cingulate cortex and other cortical structures was assessed using the h2 coefficient, following a nonlinear regression analysis of the broadband EEG signal. Poststimulation changes in connectivity were compared between two sets of stimulations eliciting or not eliciting symptoms related to body awareness (interest and control groups). We included 17 stimulations from 12 patients that reported different types of body perception changes such as sensation of being pushed toward right/left/up, one limb becoming heavier/lighter, illusory sensation of movement, sensation of pressure, sensation of floating or detachment of one hemi-body. High-frequency stimulation in the cingulate cortex (1 anterior, 15 middle, 1 posterior part) elicits body perception changes, associated with a decreased connectivity of the dominant posterior insula and increased coupling between other structures, located particularly in the nondominant hemisphere.
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Grants
- COFUND-FLAGERA II-CAUSALTOMICS Unitatea Executiva pentru Finantarea Invatamantului Superior, a Cercetarii, Dezvoltarii si Inovarii
- COFUND-FLAGERA II-SCALES Unitatea Executiva pentru Finantarea Invatamantului Superior, a Cercetarii, Dezvoltarii si Inovarii
- PN-III-P1-1.1-TE-2016-0706 Unitatea Executiva pentru Finantarea Invatamantului Superior, a Cercetarii, Dezvoltarii si Inovarii
- PN-III-P4-ID-PCE-2016-0588 Unitatea Executiva pentru Finantarea Invatamantului Superior, a Cercetarii, Dezvoltarii si Inovarii
- European Commission
- Unitatea Executiva pentru Finantarea Invatamantului Superior, a Cercetarii, Dezvoltarii si Inovarii
- European Commission
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Affiliation(s)
- Irina Popa
- Neurology DepartmentUniversity Emergency Hospital BucharestBucharestRomania
- Neurology DepartmentUniversity of Medicine and Pharmacy “Carol Davila”BucharestRomania
| | - Andrei Barborica
- Physics DepartmentUniversity of BucharestBucharestRomania
- FHC Inc.BowdoinMaine
| | - Julia Scholly
- Neurology DepartmentStrasbourg University HospitalStrasbourgFrance
| | - Cristian Donos
- Physics DepartmentUniversity of BucharestBucharestRomania
| | - Fabrice Bartolomei
- Aix Marseille Univ, APHM, INSERM, INS, Inst Neurosci SystTimone Hospital, Clinical NeurophysiologyMarseilleFrance
| | - Stanislas Lagarde
- Aix Marseille Univ, APHM, INSERM, INS, Inst Neurosci SystTimone Hospital, Clinical NeurophysiologyMarseilleFrance
| | - Edouard Hirsch
- Neurology DepartmentStrasbourg University HospitalStrasbourgFrance
| | | | | | | | - Andrei Daneasa
- Neurology DepartmentUniversity Emergency Hospital BucharestBucharestRomania
| | - Jean Ciurea
- Neurosurgery DepartmentBagdasar‐Arseni HospitalBucharestRomania
| | - Ovidiu‐Alexandru Bajenaru
- Neurology DepartmentUniversity Emergency Hospital BucharestBucharestRomania
- Neurology DepartmentUniversity of Medicine and Pharmacy “Carol Davila”BucharestRomania
| | - Ioana Mindruta
- Neurology DepartmentUniversity Emergency Hospital BucharestBucharestRomania
- Neurology DepartmentUniversity of Medicine and Pharmacy “Carol Davila”BucharestRomania
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Hebbink J, van Blooijs D, Huiskamp G, Leijten FSS, van Gils SA, Meijer HGE. A Comparison of Evoked and Non-evoked Functional Networks. Brain Topogr 2018; 32:405-417. [PMID: 30523480 PMCID: PMC6476864 DOI: 10.1007/s10548-018-0692-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 11/29/2018] [Indexed: 12/13/2022]
Abstract
The growing interest in brain networks to study the brain's function in cognition and diseases has produced an increase in methods to extract these networks. Typically, each method yields a different network. Therefore, one may ask what the resulting networks represent. To address this issue we consider electrocorticography (ECoG) data where we compare three methods. We derive networks from on-going ECoG data using two traditional methods: cross-correlation (CC) and Granger causality (GC). Next, connectivity is probed actively using single pulse electrical stimulation (SPES). We compare the overlap in connectivity between these three methods as well as their ability to reveal well-known anatomical connections in the language circuit. We find that strong connections in the CC network form more or less a subset of the SPES network. GC and SPES are related more weakly, although GC connections coincide more frequently with SPES connections compared to non-existing SPES connections. Connectivity between the two major hubs in the language circuit, Broca's and Wernicke's area, is only found in SPES networks. Our results are of interest for the use of patient-specific networks obtained from ECoG. In epilepsy research, such networks form the basis for methods that predict the effect of epilepsy surgery. For this application SPES networks are interesting as they disclose more physiological connections compared to CC and GC networks.
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Affiliation(s)
- Jurgen Hebbink
- Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
- Department of Applied Mathematics, MIRA Institute for Biomedical Engineering and Technical Medicine, University of Twente, Drienerlolaan 5, 7500 AE, Enschede, The Netherlands.
| | - Dorien van Blooijs
- Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Geertjan Huiskamp
- Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Frans S S Leijten
- Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Stephan A van Gils
- Department of Applied Mathematics, MIRA Institute for Biomedical Engineering and Technical Medicine, University of Twente, Drienerlolaan 5, 7500 AE, Enschede, The Netherlands
| | - Hil G E Meijer
- Department of Applied Mathematics, MIRA Institute for Biomedical Engineering and Technical Medicine, University of Twente, Drienerlolaan 5, 7500 AE, Enschede, The Netherlands
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31
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Mălîia MD, Donos C, Barborica A, Popa I, Ciurea J, Cinatti S, Mîndruţă I. Functional mapping and effective connectivity of the human operculum. Cortex 2018; 109:303-321. [PMID: 30414541 DOI: 10.1016/j.cortex.2018.08.024] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 05/05/2018] [Accepted: 08/27/2018] [Indexed: 11/30/2022]
Abstract
The operculum, defined as the cortex adjacent to the insula, is a large structure encompassing three lobes, with a recognized role in a variety of neurologic and psychiatric conditions. Its complex functions include sensory, motor, autonomic and cognitive processing. In humans, these are extended with the addition of language. These functions are implemented by highly specialized neuronal populations and their widespread connections, which our study aims at mapping in detail. We studied a group of 31 patients that were explored with intracranial electrodes during the pre-surgical workup for drug-resistant epilepsy. We have selected the subset of contacts implanted in non-epileptogenic opercular cortex and we analyzed the neurophysiological and behavioral responses to direct electrical stimulation. The functional mapping was performed by applying 1 Hz and 50 Hz electrical stimulation on 252 contact pairs and recording the threshold for evoking clinical effects. The effective connectivity was assessed using cortico-cortical evoked potentials elicited by single-pulse electrical stimulation in a subset of 19 patients. The locations of the effects grouped in twelve distinct semiological classes were analyzed. The most frequent effects evoked by stimulation of the frontal operculum were language related (29%). The Rolandic area produced most often oropharyngeal symptoms (47%), the parietal operculum produced somatosensory effects (67%), while the temporal evoked auditory (58%) semiology. The connectivity pattern was complex, with these structures having widespread ipsilateral and contralateral projections. The local connections between the opercular subregions and with the insula, as well as with more distant areas like the cingulate gyrus, were distinguished by strength and between-subjects consistency. In conclusion, we demonstrate specific opercular functionality, distinct from the one of the insular cortex. The study is complemented by a literature review on the opercular functional connectome in human and non-human primates.
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Affiliation(s)
- Mihai-Dragoş Mălîia
- Neurology Department, University Emergency Hospital, Bucharest, Romania; Physics Department, University of Bucharest, Bucharest, Romania
| | - Cristian Donos
- Physics Department, University of Bucharest, Bucharest, Romania
| | - Andrei Barborica
- Physics Department, University of Bucharest, Bucharest, Romania; FHC Inc., Bowdoin, ME, USA
| | - Irina Popa
- Neurology Department, University Emergency Hospital, Bucharest, Romania; Neurology Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Jean Ciurea
- Neurosurgery Department, Bagdasar-Arseni Hospital, Bucharest, Romania
| | - Sandra Cinatti
- Neurology Department, University Emergency Hospital, Bucharest, Romania
| | - Ioana Mîndruţă
- Neurology Department, University Emergency Hospital, Bucharest, Romania; Neurology Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
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32
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Trebaul L, Deman P, Tuyisenge V, Jedynak M, Hugues E, Rudrauf D, Bhattacharjee M, Tadel F, Chanteloup-Foret B, Saubat C, Reyes Mejia GC, Adam C, Nica A, Pail M, Dubeau F, Rheims S, Trébuchon A, Wang H, Liu S, Blauwblomme T, Garcés M, De Palma L, Valentin A, Metsähonkala EL, Petrescu AM, Landré E, Szurhaj W, Hirsch E, Valton L, Rocamora R, Schulze-Bonhage A, Mindruta I, Francione S, Maillard L, Taussig D, Kahane P, David O. Probabilistic functional tractography of the human cortex revisited. Neuroimage 2018; 181:414-429. [PMID: 30025851 PMCID: PMC6150949 DOI: 10.1016/j.neuroimage.2018.07.039] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 06/21/2018] [Accepted: 07/15/2018] [Indexed: 12/13/2022] Open
Abstract
In patients with pharmaco-resistant focal epilepsies investigated with intracranial electroencephalography (iEEG), direct electrical stimulations of a cortical region induce cortico-cortical evoked potentials (CCEP) in distant cerebral cortex, which properties can be used to infer large scale brain connectivity. In 2013, we proposed a new probabilistic functional tractography methodology to study human brain connectivity. We have now been revisiting this method in the F-TRACT project (f-tract.eu) by developing a large multicenter CCEP database of several thousand stimulation runs performed in several hundred patients, and associated processing tools to create a probabilistic atlas of human cortico-cortical connections. Here, we wish to present a snapshot of the methods and data of F-TRACT using a pool of 213 epilepsy patients, all studied by stereo-encephalography with intracerebral depth electrodes. The CCEPs were processed using an automated pipeline with the following consecutive steps: detection of each stimulation run from stimulation artifacts in raw intracranial EEG (iEEG) files, bad channels detection with a machine learning approach, model-based stimulation artifact correction, robust averaging over stimulation pulses. Effective connectivity between the stimulated and recording areas is then inferred from the properties of the first CCEP component, i.e. onset and peak latency, amplitude, duration and integral of the significant part. Finally, group statistics of CCEP features are implemented for each brain parcel explored by iEEG electrodes. The localization (coordinates, white/gray matter relative positioning) of electrode contacts were obtained from imaging data (anatomical MRI or CT scans before and after electrodes implantation). The iEEG contacts were repositioned in different brain parcellations from the segmentation of patients' anatomical MRI or from templates in the MNI coordinate system. The F-TRACT database using the first pool of 213 patients provided connectivity probability values for 95% of possible intrahemispheric and 56% of interhemispheric connections and CCEP features for 78% of intrahemisheric and 14% of interhemispheric connections. In this report, we show some examples of anatomo-functional connectivity matrices, and associated directional maps. We also indicate how CCEP features, especially latencies, are related to spatial distances, and allow estimating the velocity distribution of neuronal signals at a large scale. Finally, we describe the impact on the estimated connectivity of the stimulation charge and of the contact localization according to the white or gray matter. The most relevant maps for the scientific community are available for download on f-tract. eu (David et al., 2017) and will be regularly updated during the following months with the addition of more data in the F-TRACT database. This will provide an unprecedented knowledge on the dynamical properties of large fiber tracts in human.
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Affiliation(s)
- Lena Trebaul
- Inserm, U1216, Grenoble, F-38000, France; Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, Grenoble, F-38000, France
| | - Pierre Deman
- Inserm, U1216, Grenoble, F-38000, France; Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, Grenoble, F-38000, France
| | - Viateur Tuyisenge
- Inserm, U1216, Grenoble, F-38000, France; Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, Grenoble, F-38000, France
| | - Maciej Jedynak
- Inserm, U1216, Grenoble, F-38000, France; Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, Grenoble, F-38000, France
| | - Etienne Hugues
- Inserm, U1216, Grenoble, F-38000, France; Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, Grenoble, F-38000, France
| | - David Rudrauf
- Inserm, U1216, Grenoble, F-38000, France; Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, Grenoble, F-38000, France
| | - Manik Bhattacharjee
- Inserm, U1216, Grenoble, F-38000, France; Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, Grenoble, F-38000, France
| | - François Tadel
- Inserm, U1216, Grenoble, F-38000, France; Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, Grenoble, F-38000, France
| | - Blandine Chanteloup-Foret
- Inserm, U1216, Grenoble, F-38000, France; Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, Grenoble, F-38000, France
| | - Carole Saubat
- Inserm, U1216, Grenoble, F-38000, France; Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, Grenoble, F-38000, France
| | - Gina Catalina Reyes Mejia
- Inserm, U1216, Grenoble, F-38000, France; Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, Grenoble, F-38000, France
| | - Claude Adam
- Epilepsy Unit, Dept of Neurology, Pitié-Salpêtrière Hospital, APHP, Paris, France
| | - Anca Nica
- Neurology Department, CHU, Rennes, France
| | - Martin Pail
- Brno Epilepsy Center, Department of Neurology, St. Anne's University Hospital and Medical Faculty of Masaryk University, Brno, Czech Republic
| | - François Dubeau
- Montreal Neurological Institute and Hospital, Montreal, Canada
| | - Sylvain Rheims
- Department of Functional Neurology and Epileptology, Hospices Civils de Lyon and University of Lyon, Lyon, France
| | - Agnès Trébuchon
- Service de Neurophysiologie Clinique, APHM, Hôpitaux de la Timone, Marseille, France
| | - Haixiang Wang
- Yuquan Hospital Epilepsy Center, Tsinghua University, Beijing, China
| | - Sinclair Liu
- Canton Sanjiu Brain Hospital Epilepsy Center, Jinan University, Guangzhou, China
| | - Thomas Blauwblomme
- Department of Pediatric Neurosurgery, Hôpital Necker-Enfants Malades, Université Paris V Descartes, Sorbonne Paris Cité, Paris, France
| | - Mercedes Garcés
- Multidisciplinary Epilepsy Unit, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Luca De Palma
- Department of Neuroscience, Bambino Gesù Children's Hospital, IRRCS, Rome, Italy
| | - Antonio Valentin
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), London, UK
| | | | | | | | - William Szurhaj
- Epilepsy Unit, Department of Clinical Neurophysiology, Lille University Medical Center, Lille, France
| | - Edouard Hirsch
- University Hospital, Department of Neurology, Strasbourg, France
| | - Luc Valton
- University Hospital, Department of Neurology, Toulouse, France
| | - Rodrigo Rocamora
- Epilepsy Monitoring Unit, Department of Neurology, Hospital del Mar-IMIM, Barcelona, Spain
| | - Andreas Schulze-Bonhage
- Epilepsy Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Ioana Mindruta
- Neurology Department, University Emergency Hospital, Bucharest, Romania
| | | | - Louis Maillard
- Centre Hospitalier Universitaire de Nancy, Nancy, France
| | - Delphine Taussig
- Service de neurochirurgie pédiatrique, Fondation Rothschild, Paris, France
| | - Philippe Kahane
- Inserm, U1216, Grenoble, F-38000, France; Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, Grenoble, F-38000, France; CHU Grenoble Alpes, Neurology Department, Grenoble, France
| | - Olivier David
- Inserm, U1216, Grenoble, F-38000, France; Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, Grenoble, F-38000, France.
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Alarcón G, Jiménez-Jiménez D, Valentín A, Martín-López D. Characterizing EEG Cortical Dynamics and Connectivity with Responses to Single Pulse Electrical Stimulation (SPES). Int J Neural Syst 2018; 28:1750057. [DOI: 10.1142/s0129065717500575] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Objectives: To model cortical connections in order to characterize their oscillatory behavior and role in the generation of spontaneous electroencephalogram (EEG). Methods: We studied averaged responses to single pulse electrical stimulation (SPES) from the non-epileptogenic hemisphere of five patients assessed with intracranial EEG who became seizure free after contralateral temporal lobectomy. Second-order control system equations were modified to characterize the systems generating a given response. SPES responses were modeled as responses to a unit step input. EEG power spectrum was calculated on the 20[Formula: see text]s preceding SPES. Results: 121 channels showed responses to 32 stimulation sites. A single system could model the response in 41.3% and two systems were required in 58.7%. Peaks in the frequency response of the models tended to occur within the frequency range of most activity on the spontaneous EEG. Discrepancies were noted between activity predicted by models and activity recorded in the spontaneous EEG. These discrepancies could be explained by the existence of alpha rhythm or interictal epileptiform discharges. Conclusions: Cortical interactions shown by SPES can be described as control systems which can predict cortical oscillatory behavior. The method is unique as it describes connectivity as well as dynamic interactions.
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Affiliation(s)
- Gonzalo Alarcón
- Comprehensive Epilepsy Center Neuroscience Institute, Academic Health Systems, Hamad Medical Corporation, Doha, Qatar
- Department of Clinical Neuroscience, King’s College London, Institute of Psychiatry, Psychology and Neuroscience London, UK
- Department of Clinical Neurophysiology, King’s College Hospital NHS FT, London, UK
- Weill Cornell Medical College, Doha, Qatar
| | - Diego Jiménez-Jiménez
- Department of Clinical Neuroscience, King’s College London, Institute of Psychiatry, Psychology and Neuroscience London, UK
- Department of Clinical Neurophysiology, King’s College Hospital NHS FT, London, UK
- Universidad San Francisco de Quito, School of Medicine, Quito, Ecuador
| | - Antonio Valentín
- Department of Clinical Neuroscience, King’s College London, Institute of Psychiatry, Psychology and Neuroscience London, UK
- Department of Clinical Neurophysiology, King’s College Hospital NHS FT, London, UK
- Weill Cornell Medical College, Doha, Qatar
| | - David Martín-López
- Department of Clinical Neuroscience, King’s College London, Institute of Psychiatry, Psychology and Neuroscience London, UK
- Weill Cornell Medical College, Doha, Qatar
- Department of Clinical Neurophysiology, Kingston Hospital NHS FT, London, UK
- Department of Clinical Neurophysiology, St George’s University Hospitals NHS FT, London, UK
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Prime D, Rowlands D, O'Keefe S, Dionisio S. Considerations in performing and analyzing the responses of cortico-cortical evoked potentials in stereo-EEG. Epilepsia 2017; 59:16-26. [DOI: 10.1111/epi.13939] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2017] [Indexed: 12/14/2022]
Affiliation(s)
- David Prime
- Griffith University School of Engineering; Brisbane Qld Australia
- Mater Advanced Epilepsy Unit; Mater Hospital; Brisbane Qld Australia
| | - David Rowlands
- Griffith University School of Engineering; Brisbane Qld Australia
| | - Steven O'Keefe
- Griffith University School of Engineering; Brisbane Qld Australia
| | - Sasha Dionisio
- Mater Advanced Epilepsy Unit; Mater Hospital; Brisbane Qld Australia
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Donos C, Mîndruţă I, Malîia MD, Raşină A, Ciurea J, Barborica A. Co-occurrence of high-frequency oscillations and delayed responses evoked by intracranial electrical stimulation in stereo-EEG studies. Clin Neurophysiol 2017; 128:1043-1052. [DOI: 10.1016/j.clinph.2016.11.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 11/23/2016] [Accepted: 11/30/2016] [Indexed: 10/20/2022]
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Single pulse electrical stimulation and high-frequency oscillations, a complicated marriage. Clin Neurophysiol 2017; 128:1026-1027. [PMID: 28341565 DOI: 10.1016/j.clinph.2017.02.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 02/22/2017] [Indexed: 11/23/2022]
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Amengual JL, Vernet M, Adam C, Valero-Cabré A. Local entrainment of oscillatory activity induced by direct brain stimulation in humans. Sci Rep 2017; 7:41908. [PMID: 28256510 PMCID: PMC5335652 DOI: 10.1038/srep41908] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 01/03/2017] [Indexed: 11/28/2022] Open
Abstract
In a quest for direct evidence of oscillation entrainment, we analyzed intracerebral electroencephalographic recordings obtained during intracranial electrical stimulation in a cohort of three medication-resistant epilepsy patients tested pre-surgically. Spectral analyses of non-epileptogenic cerebral sites stimulated directly with high frequency electrical bursts yielded episodic local enhancements of frequency-specific rhythmic activity, phase-locked to each individual pulse. These outcomes reveal an entrainment of physiological oscillatory activity within a frequency band dictated by the rhythm of the stimulation source. Our results support future uses of rhythmic stimulation to elucidate the causal contributions of synchrony to specific aspects of human cognition and to further develop the therapeutic manipulation of dysfunctional rhythmic activity subtending the symptoms of some neuropsychiatric conditions.
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Affiliation(s)
- Julià L Amengual
- CNRS UMR 7225, Institut du Cerveau et de la Moelle Epinière, Cerebral Dynamics, Plasticity and Rehabilitaion Group, Frontlab, Paris, France
| | - Marine Vernet
- CNRS UMR 7225, Institut du Cerveau et de la Moelle Epinière, Cerebral Dynamics, Plasticity and Rehabilitaion Group, Frontlab, Paris, France
| | - Claude Adam
- Epilepsy Unit, Dept. of Neurology, Pitié-Salpêtrière Hospital, APHP, Paris, France
| | - Antoni Valero-Cabré
- CNRS UMR 7225, Institut du Cerveau et de la Moelle Epinière, Cerebral Dynamics, Plasticity and Rehabilitaion Group, Frontlab, Paris, France.,Department of Anatomy and Neurobiology, Laboratory of Cerebral Dynamics, Boston University School of Medicine, Boston, MA, USA.,Cognitive Neuroscience and Information Technology Research Program, Open University of Catalonia (UOC), Barcelona, Spain
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van 't Klooster MA, van Klink NEC, van Blooijs D, Ferrier CH, Braun KPJ, Leijten FSS, Huiskamp GJM, Zijlmans M. Evoked versus spontaneous high frequency oscillations in the chronic electrocorticogram in focal epilepsy. Clin Neurophysiol 2017; 128:858-866. [PMID: 28258937 DOI: 10.1016/j.clinph.2017.01.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 12/15/2016] [Accepted: 01/26/2017] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Spontaneous high frequency oscillations (HFOs; ripples 80-250Hz, fast ripples (FRs) 250-500Hz) are biomarkers for epileptogenic tissue in focal epilepsy. Single pulse electrical stimulation (SPES) can evoke HFOs. We hypothesized that stimulation distinguishes pathological from physiological ripples and compared the occurrence of evoked and spontaneous HFOs within the seizure onset zone (SOZ) and eloquent functional areas. METHODS Ten patients underwent SPES during 2048Hz electrocorticography (ECoG). Evoked HFOs in time-frequency plots and spontaneous HFOs were visually analyzed. We compared electrodes with evoked and spontaneous HFOs for: percentages in the SOZ, sensitivity and specificity for the SOZ, percentages in functional areas outside the SOZ. RESULTS Two patients without spontaneous FRs showed evoked FRs in the SOZ. Percentages of evoked and spontaneous HFOs in the SOZ were similar (ripples 32:33%, p=0.77; FRs 43:48%, p=0.63), but evoked HFOs had generally a lower specificity (ripples 45:69%, p=0.02; FRs 83:92%, p=0.04) and higher sensitivity (ripples 85:70%, p=0.27; FRs 52:37%, p=0.05). More electrodes with evoked than spontaneous ripples were found in functional (54:30%, p=0.03) and 'silent' areas (57:27%, p=0.01) outside the SOZ. CONCLUSIONS SPES can elicit SOZ-specific FRs in patients without spontaneous FRs, but activates ripples in all areas. SIGNIFICANCE SPES is an alternative for waiting for spontaneous HFOs, but does not warrant exclusively pathological ripples.
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Affiliation(s)
- M A van 't Klooster
- Brain Center Rudolf Magnus, Department of Neurology and Neurosurgery, University Medical Center Utrecht, The Netherlands.
| | - N E C van Klink
- Brain Center Rudolf Magnus, Department of Neurology and Neurosurgery, University Medical Center Utrecht, The Netherlands
| | - D van Blooijs
- Brain Center Rudolf Magnus, Department of Neurology and Neurosurgery, University Medical Center Utrecht, The Netherlands
| | - C H Ferrier
- Brain Center Rudolf Magnus, Department of Neurology and Neurosurgery, University Medical Center Utrecht, The Netherlands
| | - K P J Braun
- Brain Center Rudolf Magnus, Department of Neurology and Neurosurgery, University Medical Center Utrecht, The Netherlands
| | - F S S Leijten
- Brain Center Rudolf Magnus, Department of Neurology and Neurosurgery, University Medical Center Utrecht, The Netherlands
| | - G J M Huiskamp
- Brain Center Rudolf Magnus, Department of Neurology and Neurosurgery, University Medical Center Utrecht, The Netherlands
| | - M Zijlmans
- Brain Center Rudolf Magnus, Department of Neurology and Neurosurgery, University Medical Center Utrecht, The Netherlands; Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, The Netherlands
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High frequency spectral changes induced by single-pulse electric stimulation: Comparison between physiologic and pathologic networks. Clin Neurophysiol 2016; 128:1053-1060. [PMID: 28131532 DOI: 10.1016/j.clinph.2016.12.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 12/05/2016] [Accepted: 12/15/2016] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To investigate functional coupling between brain networks using spectral changes induced by single-pulse electric stimulation (SPES). METHOD We analyzed 20 patients with focal epilepsy, implanted with depth electrodes. SPES was applied to each pair of adjacent contacts, and responses were recorded from all other contacts. The mean response amplitude value was quantified in three time-periods after stimulation (10-60, 60-255, 255-500ms) for three frequency-ranges (Gamma, Ripples, Fast-Ripples), and compared to baseline. A total of 30,755 responses were analyzed, taking into consideration three dichotomous pairs: stimulating in primary sensory areas (S1-V1) vs. outside them, to test the interaction in physiologic networks; stimulating in seizure onset zone (SOZ) vs. non-SOZ, to test pathologic interactions; recording in default mode network (DMN) vs. non-DMN. RESULTS Overall, we observed an early excitation (10-60ms) and a delayed inhibition (60-500ms). More specifically, in the delayed period, stimulation in S1-V1 produced a higher gamma-inhibition in the DMN, while stimulation in the SOZ induced a higher inhibition in the epilepsy-related higher frequencies (Ripples and Fast-Ripples). CONCLUSION Physiologic and pathologic interactions can be assessed using spectral changes induced by SPES. SIGNIFICANCE This is a promising method for connectivity studies in patients with drug-resistant focal epilepsy.
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Electrical Stimulation for Seizure Induction and Functional Mapping in Stereoelectroencephalography. J Clin Neurophysiol 2016; 33:511-521. [DOI: 10.1097/wnp.0000000000000313] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Popa I, Donos C, Barborica A, Opris I, Mălîia MD, Ene M, Ciurea J, Mîndruţă I. Intrusive Thoughts Elicited by Direct Electrical Stimulation during Stereo-Electroencephalography. Front Neurol 2016; 7:114. [PMID: 27486431 PMCID: PMC4947963 DOI: 10.3389/fneur.2016.00114] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 07/06/2016] [Indexed: 12/12/2022] Open
Abstract
Cortical direct electrical stimulation (DES) is a method of brain mapping used during invasive presurgical evaluation of patients with intractable epilepsy. Intellectual auras like intrusive thoughts, also known as forced thinking (FT), have been reported during frontal seizures. However, there are few reports on FT obtained during DES in frontal cortex. We report three cases in which we obtained intrusive thoughts while stimulating the dorsolateral prefrontal cortex and the white matter in the prefrontal region. In order to highlight the effective connectivity that might explain this clinical response, we have analyzed cortico-cortical potentials evoked by single pulse electrical stimulation.
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Affiliation(s)
- Irina Popa
- Department of Neurology, University Emergency Hospital , Bucharest , Romania
| | - Cristian Donos
- Department of Physics, University of Bucharest, Bucharest, Romania; Epilepsy Center, University Hospital of Freiburg, Freiburg, Germany
| | - Andrei Barborica
- Department of Physics, University of Bucharest, Bucharest, Romania; FHC Inc., Bowdoin, ME, USA
| | - Ioan Opris
- Department of Neurosurgery, Bagdasar-Arseni Emergency Hospital , Bucharest , Romania
| | - Mihai Dragoş Mălîia
- Department of Neurology, University Emergency Hospital , Bucharest , Romania
| | - Mirela Ene
- Department of Physics, University of Bucharest , Bucharest , Romania
| | - Jean Ciurea
- Department of Neurological Surgery, Miller School of Medicine, University of Miami , Miami, FL , USA
| | - Ioana Mîndruţă
- Department of Neurology, University Emergency Hospital, Bucharest, Romania; Department of Neurology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
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A connectomics approach combining structural and effective connectivity assessed by intracranial electrical stimulation. Neuroimage 2016; 132:344-358. [DOI: 10.1016/j.neuroimage.2016.02.054] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 01/31/2016] [Accepted: 02/17/2016] [Indexed: 10/22/2022] Open
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Trebaul L, Rudrauf D, Job AS, Mălîia MD, Popa I, Barborica A, Minotti L, Mîndruţă I, Kahane P, David O. Stimulation artifact correction method for estimation of early cortico-cortical evoked potentials. J Neurosci Methods 2016; 264:94-102. [PMID: 26952846 PMCID: PMC4840016 DOI: 10.1016/j.jneumeth.2016.03.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 03/01/2016] [Accepted: 03/02/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND Effective connectivity can be explored using direct electrical stimulations in patients suffering from drug-resistant focal epilepsies and investigated with intracranial electrodes. Responses to brief electrical pulses mimic the physiological propagation of signals and manifest as cortico-cortical evoked potentials (CCEP). The first CCEP component is believed to reflect direct connectivity with the stimulated region but the stimulation artifact, a sharp deflection occurring during a few milliseconds, frequently contaminates it. NEW METHOD In order to recover the characteristics of early CCEP responses, we developed an artifact correction method based on electrical modeling of the electrode-tissue interface. The biophysically motivated artifact templates are then regressed out of the recorded data as in any classical template-matching removal artifact methods. RESULTS Our approach is able to make the distinction between the physiological responses time-locked to the stimulation pulses and the non-physiological component. We tested the correction on simulated CCEP data in order to quantify its efficiency for different stimulation and recording parameters. We demonstrated the efficiency of the new correction method on simulations of single trial recordings for early responses contaminated with the stimulation artifact. The results highlight the importance of sampling frequency for an accurate analysis of CCEP. We then applied the approach to experimental data. COMPARISON WITH EXISTING METHOD The model-based template removal was compared to a correction based on the subtraction of the averaged artifact. CONCLUSIONS This new correction method of stimulation artifact will enable investigators to better analyze early CCEP components and infer direct effective connectivity in future CCEP studies.
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Affiliation(s)
- Lena Trebaul
- Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, F-38000 Grenoble, France; Inserm, U1216, F-38000 Grenoble, France
| | - David Rudrauf
- Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, F-38000 Grenoble, France; Inserm, U1216, F-38000 Grenoble, France
| | - Anne-Sophie Job
- Inserm, U1216, F-38000 Grenoble, France; Laboratoire de Neurophysiopathologie de l'Epilepsie, Centre Hospitalier Universitaire Grenoble-Alpes, Grenoble, France
| | | | - Irina Popa
- Neurology Department, University Emergency Hospital, Bucharest, Romania
| | - Andrei Barborica
- Physics Department, University of Bucharest, Bucharest, Romania; FHC Inc, Bowdoin, ME, USA
| | - Lorella Minotti
- Inserm, U1216, F-38000 Grenoble, France; Laboratoire de Neurophysiopathologie de l'Epilepsie, Centre Hospitalier Universitaire Grenoble-Alpes, Grenoble, France
| | - Ioana Mîndruţă
- Neurology Department, University Emergency Hospital, Bucharest, Romania; Neurology Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Philippe Kahane
- Inserm, U1216, F-38000 Grenoble, France; Laboratoire de Neurophysiopathologie de l'Epilepsie, Centre Hospitalier Universitaire Grenoble-Alpes, Grenoble, France
| | - Olivier David
- Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, F-38000 Grenoble, France; Inserm, U1216, F-38000 Grenoble, France.
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