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Soulier H, Mauguière F, Catenoix H, Montavont A, Isnard J, Rheims S, Mazzola L. OC03 : Visceral responses to direct electrical stimulation of the Human cortex. Clin Neurophysiol 2022. [DOI: 10.1016/j.clinph.2021.11.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Chouchou F, Pichot V, Corbier C, Mauguière F, Rheims S, Mazzola L. HP09: Cardiac reactivity to electric brain stimulations: A SEEG study. Clin Neurophysiol 2022. [DOI: 10.1016/j.clinph.2021.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Chabanat E, Jacquin-Courtois S, Havé L, Kihoulou C, Tilikete C, Mauguière F, Rheims S, Rossetti Y. Can you guess the colour of this moving object? A dissociation between colour and motion in blindsight. Neuropsychologia 2018; 128:204-208. [PMID: 30102905 DOI: 10.1016/j.neuropsychologia.2018.08.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 06/01/2018] [Accepted: 08/08/2018] [Indexed: 10/28/2022]
Abstract
Blindsight has been primarily and extensively studied by Lawrence Weiskrantz. Residual visual abilities following a hemispheric lesion leading to homonymous hemianopia encompass a variety of visual-perceptual and visuo-motor functions. Attention blindsight produces the more salient subjective experiences, especially for motion (Riddoch phenomenon). Action blindsight illustrates visuo-motor abilities despite the patients' feeling that they produce random movements. Perception blindsight seems to be the weakest residual function observed in blindsight, e.g. for wavelength sensitivity. Discriminating motion produced by isoluminant colours does not give rise to blindsight for motion but the outcome of the reciprocal test is not known. Here we tested whether moving stimuli could give rise to colour discrimination in a patient with homonymous hemianopia. It was found that even though the patient exhibited nearly perfect performances for motion direction discrimination his colour discrimination for the same moving stimulus remained at chance level. It is concluded that easily discriminated moving stimuli do not give rise to colour discrimination and implications for the 3 levels of blindsight taxonomy are discussed.
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Affiliation(s)
- E Chabanat
- Inserm UMR-S 1028, CNRS UMR 5292, ImpAct, Centre de Recherche en Neurosciences de Lyon, France; Université de Lyon, Université Claude Bernard Lyon 1, France.
| | - S Jacquin-Courtois
- Inserm UMR-S 1028, CNRS UMR 5292, ImpAct, Centre de Recherche en Neurosciences de Lyon, France; Université de Lyon, Université Claude Bernard Lyon 1, France; Service de rééducation neurologique, Pavillon Bourret, Hôpital Henry-Gabrielle, Hospices Civils de Lyon, 20, route de Vourles, Saint-Genis-Laval, France; Plate-forme 'Mouvement et Handicap', Hôpital Henry-Gabrielle et Hôpital Neurologique Neurologique Pierre Wertheimer, Hospices Civils de Lyon, 20, route de Vourles, Saint-Genis-Laval, France.
| | - L Havé
- Inserm UMR-S 1028, CNRS UMR 5292, ImpAct, Centre de Recherche en Neurosciences de Lyon, France; Université de Lyon, Université Claude Bernard Lyon 1, France.
| | - C Kihoulou
- Inserm UMR-S 1028, CNRS UMR 5292, ImpAct, Centre de Recherche en Neurosciences de Lyon, France
| | - C Tilikete
- Inserm UMR-S 1028, CNRS UMR 5292, ImpAct, Centre de Recherche en Neurosciences de Lyon, France; Université de Lyon, Université Claude Bernard Lyon 1, France; Service de Neuro-Cognition et Neuro-Ophtalmologie, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, 59 boulevard Pinel, 69677 Bron Cedex, France.
| | - F Mauguière
- Université de Lyon, Université Claude Bernard Lyon 1, France; Département de Neurologie Fonctionnelle et Epileptologie, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France; Inserm UMR-S 1028, CNRS UMR 5292, NeuroPain, Centre de Recherche en Neurosciences de Lyon, France.
| | - S Rheims
- Université de Lyon, Université Claude Bernard Lyon 1, France; Département de Neurologie Fonctionnelle et Epileptologie, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, France; Inserm UMR-S 1028, CNRS UMR 5292, TIGER, Centre de Recherche en Neurosciences de Lyon, France.
| | - Y Rossetti
- Inserm UMR-S 1028, CNRS UMR 5292, ImpAct, Centre de Recherche en Neurosciences de Lyon, France; Université de Lyon, Université Claude Bernard Lyon 1, France; Service de rééducation neurologique, Pavillon Bourret, Hôpital Henry-Gabrielle, Hospices Civils de Lyon, 20, route de Vourles, Saint-Genis-Laval, France; Plate-forme 'Mouvement et Handicap', Hôpital Henry-Gabrielle et Hôpital Neurologique Neurologique Pierre Wertheimer, Hospices Civils de Lyon, 20, route de Vourles, Saint-Genis-Laval, France.
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André-Obadia N, Mauguière F. Les explorations neurophysiologiques dans les tumeurs médullaires. Neurochirurgie 2017; 63:356-365. [DOI: 10.1016/j.neuchi.2016.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Revised: 08/08/2015] [Accepted: 06/12/2016] [Indexed: 11/28/2022]
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Czekala C, Mauguière F, Garcia-Larrea L, Frot M. ID 333 – Neurophysiological responses of pain facial expressions: an intracerebral electrophysiologic study. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2015.11.395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Frot M, Perchet C, Mauguière F. ID 402 – Do cortical regions encoding pain also respond to images of other’s pain? Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2015.11.397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Morizot-Koutlidis R, André-Obadia N, Antoine JC, Attarian S, Ayache S, Azabou E, Benaderette S, Camdessanché JP, Cassereau J, Convers P, d’Anglejean J, Delval A, Durand MC, Etard O, Fayet G, Fournier E, Franques J, Gavaret M, Guehl D, Guerit JM, Krim E, Kubis N, Lacour A, Lozeron P, Mauguière F, Merle PE, Mesrati F, Mutschler V, Nicolas G, Nordine T, Pautot V, Péréon Y, Petiot P, Pouget J, Praline J, Salhi H, Trébuchon A, Tyvaert L, Vial C, Zola JM, Zyss J, Lefaucheur JP. Somatosensory evoked potentials in the assessment of peripheral neuropathies: Commented results of a survey among French-speaking practitioners and recommendations for practice. Neurophysiol Clin 2015; 45:131-42. [DOI: 10.1016/j.neucli.2015.04.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 03/31/2015] [Accepted: 04/02/2015] [Indexed: 12/14/2022] Open
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Mauguière F, Corkin S. H.M. never again! An analysis of H.M.’s epilepsy and treatment. Rev Neurol (Paris) 2015; 171:273-81. [DOI: 10.1016/j.neurol.2015.01.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Revised: 01/01/2015] [Accepted: 01/27/2015] [Indexed: 12/01/2022]
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Frot M, Perchet C, Mauguière F. P1006: Are there mirror neurons for pain in the human insula? Clin Neurophysiol 2014. [DOI: 10.1016/s1388-2457(14)51041-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Catenoix H, Magnin M, Mauguière F, Ryvlin P. Evoked potential study of hippocampal efferent projections in the human brain. Clin Neurophysiol 2011; 122:2488-97. [PMID: 21669549 DOI: 10.1016/j.clinph.2011.05.007] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2011] [Revised: 04/14/2011] [Accepted: 05/15/2011] [Indexed: 11/24/2022]
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Mauguière F. R1.2 The seminal contribution of Jean Edouard Desmedt to the recording and interpretation of somatosensory evoked potentials (SEPS). Clin Neurophysiol 2011. [DOI: 10.1016/s1388-2457(11)60085-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Guénot M, Isnard J, Catenoix H, Mauguière F, Sindou M. SEEG-guided RF-thermocoagulation of epileptic foci: a therapeutic alternative for drug-resistant non-operable partial epilepsies. Adv Tech Stand Neurosurg 2011; 36:61-78. [PMID: 21197608 DOI: 10.1007/978-3-7091-0179-7_4] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND Previous literature includes numerous reports of acute stereotactic ablation for epilepsy. Most reports focus on amygdalotomies or amygdalohippocampotomies, some others focus on various extra-limbic targets. These stereotactic techniques proved to have a less favourable outcome than that of standard surgery, so that their rather disappointing benefit/risk ratio explains why they have been largely abandoned. However, depth electrode recordings may be required in some cases of epilepsy surgery to delineate the best region of cortical resection. We usually implant depth electrodes according to Talairach's stereo electroencephalography (SEEG) methodology. Using these chronically implanted depth electrodes, we are able to perform radiofrequency (RF)-thermolesions of the epileptic foci. This paper reports the technical data required to perform such multiple cortical thermolesions, as well as the results in terms of seizure outcome in a group of 41 patients. TECHNICAL DATA: Lesions are placed in the cortex areas showing either a low amplitude fast pattern or spike-wave discharges at the onset of the seizures. Interictal paroxysmal activities are not considered for planning thermocoagulation sites. All targets are first functionally evaluated using electrical stimulation. Only those showing no clinical response to stimulation are selected for thermolesion, including sites located inside or near primary functional area. Lesions are performed using 120mA bipolar current (50 V), applied for 10-30 sec. Each thermocoagulation produces a 5-7mm diameter cortical lesion. A total of 2-31 lesions were performed in each of the 41 patients. Lesions are placed without anaesthesia. RESULTS 20 patients (48.7%) experienced a seizure frequency decrease of at least 50% that was more than 80% in eight of them. One patient was seizure free after RF thermocoagulation. In 21 patients, no significant reduction of the seizure frequency was observed. Amongst the characteristics of the disease (age and sex of the patient, lobar localization of the EZ) and the characteristics of the thermocoagulations (topography, lateralization, number, morphology of the lesions on MRI) no factor was significantly linked to the outcome. However, the best results were clearly observed in epilepsies symptomatic of a cortical development malformation (CDM), with 67% of responders in this group of 20 patients (p = 0.052). Three transient post-procedure side-effects, consisting of paraesthetic sensations in the mouth (2 cases), and mild apraxia of the hand, were observed. CONCLUSION SEEG-guided-RF-thermolesioning is a safe technique. Our results indicate that such lesions can lead to a significant reduction of seizure frequency. Our experience suggests that SEEG-guided RF thermocoagulation should be dedicated to drug-resistant epileptic patients for whom conventional resection surgery is risky or contra-indicated on the basis of invasive pre-surgical evaluation, particularly those suffering from epilepsy symptomatic of cortical development malformation.
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Affiliation(s)
- M Guénot
- Service de Neurochirurgie Fonctionnelle, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron, France
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Demarquay G, Lothe A, Royet JP, Costes N, Mick G, Mauguière F, Ryvlin P. Brainstem changes in 5-HT1A receptor availability during migraine attack. Cephalalgia 2010; 31:84-94. [PMID: 21036859 DOI: 10.1177/0333102410385581] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Among serotonin receptors, 5-HT(1A) receptors are implicated in the regulation of central serotoninergic tone and could be involved in the abnormal brain 5-HT turnover suspected in migraineurs. The aim of this study was to investigate 5-HT(1A) receptors' availability during migraine attacks. METHODS Ten patients suffering from odor-triggered migraine attacks and 10 control subjects were investigated using positron emission tomography (PET) and [(18)F]MPPF PET tracer, a selective 5-HT(1A) antagonist. All subjects underwent calibrated olfactory stimulations prior to the PET study. RESULTS Four patients developed a migraine attack during the PET study. In these patients, statistical parametrical mapping and region of interest analyses showed an increased [(18)F]MPPF binding potential (BP(ND)) in the pontine raphe when compared to headache-free migraineurs and control subjects. This ictal change was confirmed at the individual level in each of the four affected patients. In comparison with the headache-free migraineurs, patients with a migraine attack also showed significantly increased [(18)F]MPPF BP(ND) in the left orbitofrontal cortex, precentral gyrus and temporal pole. No significant change in [(18)F]MPPF BP(ND) was observed between headache-free migraineurs and controls. CONCLUSIONS Our results emphasize the role of 5HT(1A) receptors in the pontine raphe nuclei during the early stage of migraine attacks.
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Affiliation(s)
- G Demarquay
- Service de Neurologie, Hôpital de la Croix-Rousse France, Lyon, France.
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Abstract
Background: The association between epilepsy and multiple sclerosis (MS) is not a coincidence. Objective: Our objective was to compare MS patients with or without history of seizures. Methods: In a population of 5041 MS patients, we identified 102 (2%) patients with epileptic seizures. In 67 patients (1.3%), epileptic seizure could not be explained by any cause other than MS. Results: In these 67 patients, the median age at occurrence of the first epileptic seizure was 33 years. Epilepsy was the initial clinical manifestation of MS in seven patients. In total, 62 patients (92.5%) presented only one or a few seizures, and 18 patients (27%) presented at least one episode of status epilepticus, fatal in two. Compared with MS patients without epilepsy, there was no difference in gender, type of MS course and time from onset of MS to the progressive phase. Conversely, the median age at MS onset was earlier (25.0 years vs. 30, p < 0.0001) and there was a trend for a shorter time from MS onset to non-reversible disability. Conclusions: Our study confirms an increased risk of epileptic seizures in MS patients. It underlines that seizures may be the first observable symptom in MS and the frequency and seriousness of status epilepticus.
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Affiliation(s)
- H Catenoix
- Service de Neurologie Fonctionnelle et d’Epileptologie, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron, France
- Université de Lyon, Lyon, France
- Institut Fédératif des Neurosciences de Lyon, Lyon, France
| | - R Marignier
- Université de Lyon, Lyon, France
- Institut Fédératif des Neurosciences de Lyon, Lyon, France
- Service de Neurologie A, European Database for Multiple Sclerosis (EDMUS) Coordinating Center
| | - C Ritleng
- Service de Neurologie A, European Database for Multiple Sclerosis (EDMUS) Coordinating Center
- INSERM U 842, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron, France
| | - M Dufour
- Service de Neurologie A, European Database for Multiple Sclerosis (EDMUS) Coordinating Center
- INSERM U 842, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron, France
| | - F Mauguière
- Service de Neurologie Fonctionnelle et d’Epileptologie, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron, France
- Université de Lyon, Lyon, France
- Institut Fédératif des Neurosciences de Lyon, Lyon, France
| | - C Confavreux
- Université de Lyon, Lyon, France
- Institut Fédératif des Neurosciences de Lyon, Lyon, France
- Service de Neurologie A, European Database for Multiple Sclerosis (EDMUS) Coordinating Center
- INSERM U 842, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron, France
| | - S Vukusic
- Université de Lyon, Lyon, France
- Institut Fédératif des Neurosciences de Lyon, Lyon, France
- Service de Neurologie A, European Database for Multiple Sclerosis (EDMUS) Coordinating Center
- INSERM U 842, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron, France
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Mazzola L, Isnard J, Peyron R, Guénot M, Mauguière F. Somatotopic organization of pain responses to direct electrical stimulation of the human insular cortex. Pain 2009; 146:99-104. [PMID: 19665303 DOI: 10.1016/j.pain.2009.07.014] [Citation(s) in RCA: 124] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2009] [Revised: 06/26/2009] [Accepted: 07/13/2009] [Indexed: 10/20/2022]
Abstract
The question whether pain encoding in the human insula shows some somatotopic organization is still pending. We studied 142 patients undergoing depth stereotactic EEG (SEEG) exploration of the insular cortex for pre-surgical evaluation of epilepsy. 472 insular electrical stimulations were delivered, of which only 49 (10.5%) elicited a painful sensation in 38 patients (27%). Most sites where low intensity electric stimulation produced pain, without after-discharge or concomitant visually detectable change in EEG activity outside the insula, were located in the posterior two thirds of the insula. Pain was located in a body area restricted to face, upper limb or lower limb for 27 stimulations (55%) and affected more than one of these regions for all others. The insular cortex being oriented parallel to the medial sagittal plane we found no significant difference between body segment representations in the medio-lateral axis. Conversely a somatotopic organization of sites where stimulation produced pain was observed along the rostro-caudal and vertical axis of the insula, showing a face representation rostral to those of upper and lower limbs, with an upper limb representation located above that of the lower limb. These data suggest that, in spite of large and often bilateral receptive fields, pain representation shows some degree of somatotopic organization in the human insula.
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Affiliation(s)
- L Mazzola
- INSERM U 879 (Central Integration of Pain), Lyon, St. Etienne, France.
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Rosenberg DS, Mauguière F, Catenoix H, Faillenot I, Magnin M. Reciprocal Thalamocortical Connectivity of the Medial Pulvinar: A Depth Stimulation and Evoked Potential Study in Human Brain. Cereb Cortex 2008; 19:1462-73. [DOI: 10.1093/cercor/bhn185] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Mauguière F. Functional connectivity of the mesial temporal lobe in humans: an electrical study. Clin Neurophysiol 2008. [DOI: 10.1016/s1388-2457(08)60530-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Lothe A, Merlet I, Demarquay G, Costes N, Ryvlin P, Mauguière F. Interictal brain 5-HT1A receptors binding in migraine without aura: a 18F-MPPF-PET study. Cephalalgia 2008; 28:1282-91. [PMID: 18727636 DOI: 10.1111/j.1468-2982.2008.01677.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In this study we aimed to assess the brain distribution of 5-HT(1A) receptors in migraine patients without aura. Ten female migraine patients and 24 female healthy volunteers underwent magnetic resonance imaging and positron emission tomography using a radioligand antagonist of 5-HT(1A) receptors [4-(2'-methoxyphenyl)-1-[2'-(N-2-pirydynyl)-p-fluorobenzamido]-ethylpiperazine ((18)F-MPPF)]. A simplified reference tissue model was used to generate parametric images of 5-HT(1A) receptor binding potential (BP) values. Statistical Parametrical Mapping (SPM) analysis showed increased MPPF BP in posterior cortical areas and hippocampi bilaterally in patients compared with controls. Region of interest (ROI) analysis showed a non-significant trend in favour of a BP increase patients in cortical regions identified by the SPM analysis except in hippocampi, left parietal areas and raphe nuclei. During the interictal period of migraine patients without aura, the increase of MPPF BP in posterior cortical and limbic areas could reflect an increase in receptor density or a decrease of endogenous serotonin, which could explain their altered cortical excitability.
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Affiliation(s)
- A Lothe
- Université de Lyon, Lyon, Inserm, U821, Bron, Institut Fédératif des Neurosciences de Lyon, France
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Barba C, Valeriani M, Colicchio G, Mauguière F. New depth short-latency somatosensory evoked potential (SEP) component recorded in human SI area. Neurosci Lett 2008; 432:179-83. [PMID: 18226449 DOI: 10.1016/j.neulet.2007.12.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2007] [Revised: 10/01/2007] [Accepted: 12/11/2007] [Indexed: 11/25/2022]
Abstract
To analyse short and long-latency (SEPs) recorded by chronically stereotactically electrodes implanted in SI area of two epileptic patients. Two drug-resistant epileptic patients (2 females, 38 and 15 years, respectively) suffering from left temporal and right frontal epilepsy respectively, were investigated by an electrode-chronically implanted in SI area. Short and long latency somatosensory evoked potentials were recorded by depth electrodes 10 days after implantation. This is the first study to describe a depth N36 response by an intracerebral recording electrode in the SI area, probably generated by a radially oriented generator, located in area 1. Furthermore, we confirmed a role of SI in the genesis of N60 component. Finally, our present data suggest that the SI area is still active at 120 ms after the stimulus, since in one patient (no. 2) we identified a N120 potential, reaching its maximal amplitude at the same depth as the N20 response.
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Affiliation(s)
- C Barba
- Neurosciences Department, Pediatric Hospital Meyer, Via Luca Giordano 13, Florence, Italy.
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Peter L, Niel F, Catenoix H, Jung J, Demarquay G, Petiot P, Rudigoz RC, Boespflug-Tanguy O, Ryvlin P, Mauguière F. Acute neurological deterioration in ovarioleukodystrophy related to EIF2B mutations: pregnancy with oocyte donation is a potentially precipitating factor. Eur J Neurol 2007; 15:94-7. [PMID: 18005052 DOI: 10.1111/j.1468-1331.2007.01999.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Mutations in the eukaryotic translation initiation factor 2B (eIF2B) represent a heterogenous group of autosomal recessive leucodystrophy characterized by a diffuse CSF-like aspect of the white matter at MRI designed as vanishing white matter (VWM) and episodes of acute deterioration after stresses. The mild juvenile and adult forms are often associated with primary ovarian failure, a syndrome referred to as ovarioleukodystrophy (OLD). We reported case of a woman with OLD who successfully underwent in vitro fertilization with donated oocytes and embryo transfer. Pregnancy was complicated by a non-convulsive epileptic status leading to the identification of compound heterozygous EIF2B5 mutation (p.Arg113His and p.Arg299His). The patient gave birth to a healthy child by Caesarean section. In conclusion, we report for the first time that in vitro fertilization and embryo transfer can lead to a successful procreation in patients with OLD related to EIF2B mutations. However this procedure must be considered with cautiousness, because of its potential neurological risks.
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Affiliation(s)
- L Peter
- CHU de Lyon, Service d'Epileptologie, Hôpital Neurologique, Lyon Cedex 3, France.
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Mauguière F. [Epileptogenicity and evaluation of epileptic risk]. Neurochirurgie 2007; 53:156-62. [PMID: 17507046 DOI: 10.1016/j.neuchi.2007.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2007] [Accepted: 03/22/2007] [Indexed: 11/18/2022]
Abstract
Epilepsy is the more frequent clinical manifestation of hemispheric cavernomas in 50 to 75% of symptomatic cases; the annual risk of a first seizure is evaluated from 1.5 to 2.5%. As for all epileptogenic lesions, many questions arise: Is the pathologic tissue or the perilesional cortex responsible for the epileptic symptoms? Is the risk related with the topography of the lesion? Is the prognosis of the epilepsy related with the number of seizures? Can the epilepsy become drug-resistant? Can surgical treatment cure the epilepsy? When surgery is indicated, should lesionectomy alone or lesionectomy plus perilesional tissue resection be performed? The iron and the hemosiderin deposits induce metabolic perturbations and tissue reorganization (gliosis and sclerosis) around the cavernoma. These cortical modifications seem to be responsible for the epileptic discharges but this is difficult to demonstrate. Epileptic discharges have been recorded in the perilesional tissue in only one study of the literature. Drug therapy can usually control the seizures, but it appears that surgery is more effective when the epilepsy is recent and the seizures are not too frequent. For these reasons it would appear licit to propose the resection of the lesion when the surgical risk is not too great. In case of drug-resistant epilepsy, the same function-targeted surgical strategy may be used as for the management of any severe epilepsy.
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Affiliation(s)
- F Mauguière
- Service de neurologie fonctionnelle et d'épileptologie, hôpital neurologique, groupement hospitalier Est, hospices civils de Lyon (HCL), 59 boulevard Pinel 69394, Lyon cedex 03, France.
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Jung J, Mauguière F, Clerc-Renaud P, Ollagnon E, Mousson de Camaret B, Ryvlin P. NARP MITOCHONDRIOPATHY: AN UNUSUAL CAUSE OF PROGRESSIVE MYOCLONIC EPILEPSY. Neurology 2007; 68:1429-30. [PMID: 17452590 DOI: 10.1212/01.wnl.0000264019.53959.10] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- J Jung
- Hôpital Neurologique, Service de Neurologie Fonctionnelle et d'Epileptologie, Bron, France.
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Nang A, Mauguière F. A - 20 Épilepsie et cannabis — actualités. Rev Neurol (Paris) 2007. [DOI: 10.1016/s0035-3787(07)90785-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Mauguière F, Fischer C, André-Obadia N. Potenziali evocati in neurologia: risposte patologiche e indicazioni. Neurologia 2007. [DOI: 10.1016/s1634-7072(07)70547-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Mauguière F, Fischer C. Potenziali evocati in neurologia: risposte normali. Neurologia 2007. [DOI: 10.1016/s1634-7072(07)70546-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Guénot M, Isnard J, Catenoix H, Ryvlin P, Mauguière F, Sindou M. Apport actuel de la SEEG dans le bilan pré-chirurgical de l’épilepsie temporale pharmaco-résistante. Neurochirurgie 2006. [DOI: 10.1016/s0028-3770(06)71266-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Abstract
In this second part, we address particularly the question of the neural mechanisms and structures involved in the recognition of facial emotional expressions that are crucial in social cognition. Emotion recognition in others can be critically impaired in some neurodegenerative and neurovascular diseases. That dysfunction sometimes correlated to disabling behavioural disorders and interpersonal communication impairment must be further understood. The results of a series of scalp and intracranial event related potential recordings, as well as recent advances in the literature, are reported. ERPs to facial emotional expressions were thus recorded in multiple subcortical and cortical areas in drug refractory epileptical patients implanted with depth electrodes. The roles of amygdala, insula and prefrontal cortex located at crossroads between perceptive analysis and emotional conceptual knowledge are particularly underlined. Altogether, these studies demonstrate that facial expressions are widely processed in space and time, some structures reacting very early and automatically, others providing a sustained reaction depending on the attention.
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Abstract
Faces represent a crucial vector of interhuman communication. The message transmitted by the face has multiple features. Recognition of each feature can be impaired independently or in combination with others. In order to understand the behavioral consequences of such impairments, which can be a major social handicap, we first must specify the neural networks involved in face recognition. We propose in this first part to present the systems involved in face recognition, in particular the question of identity and prosopagnosia. Different neural networks are indeed implicated in the recognition of invariant facial features such as identity, gender, ethnicity, and recognition of variant features like facial expression and eye gaze. This paper is illustrated by some of our scalp and intracranial electrophysiological studies performed in humans allowing us to describe some aspects of face recognition dynamics combining an excellent spatial and temporal resolution. Intracranial recordings were performed in drug refractory epileptical patients implanted with depth electrodes. These studies demonstrate that numerous deep brain and cortical structures participate early and sometimes in a sustained manner in face recognition.
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Mauguière F. CS2.3 What do intracranial signals teach us on pain physiology: The model of epileptic pain. Clin Neurophysiol 2006. [DOI: 10.1016/j.clinph.2006.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Mauguière F, Bousser M. Séance du 19 janvier 2006. Rev Neurol (Paris) 2006. [DOI: 10.1016/s0035-3787(06)75029-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Sindou M, Guenot M, Isnard J, Ryvlin P, Fischer C, Mauguière F. Temporo-mesial epilepsy surgery: outcome and complications in 100 consecutive adult patients. Acta Neurochir (Wien) 2006; 148:39-45. [PMID: 16283106 DOI: 10.1007/s00701-005-0644-x] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2005] [Accepted: 09/01/2005] [Indexed: 10/25/2022]
Abstract
BACKGROUND We studied the surgical outcome, and the complications in a group of 100 consecutive adult patients with medically refractory epilepsy arising from the temporo-mesial structures. METHODS Hundred patients were treated surgically between 1994 and 2003 for drug-resistant epilepsy involving the temporo-mesial structures. All of them underwent a comprehensive noninvasive presurgical evaluation. Fourty-eight of them underwent depth electrodes recordings (according to the Talairach's StereoElectroEncephaloGraphic (SEEG) methodology) because the noninvasive investigations were not congruent enough to identify the epileptic zone. The patients presenting with any space-occupying lesion, or with a cavernoma, or with a strictly lateral neocortical epileptic focus, were excluded. The MRI-examination was abnormal in 87 cases, displaying a hippocampal atrophy in 69 cases. The extent of temporal resection was planned according to the results of the presurgical investigation in each particular patient. Consequently, this "tailored" resection varied from selective amygdalo-hippocampectomy (6 cases), to anterior temporal lobectomy (76 cases), or to total temporal lobectomy (18 cases). FINDINGS The mean post-operative follow-up period was 53 months. 85 patients were found to be in Engel's class I post-operatively (free of disabling seizures), among them 74 were in class Ia (totally seizure free). Nine patients were in Engel's class II and six were in Engel's class III or IV (failures). There was no surgical mortality. Three patients had a postoperative hematoma; two patients required a shunt insertion; in three patients meningitis occurred; and two patients had postoperative ischaemia of the anterior choroidal artery territory, which resulted in a mild permanent hemiparesis. Neuropsychological complications are not addressed in detail in this article. CONCLUSIONS These data indicate that "tailored" resective surgery for temporo-mesial epilepsy can be performed with a low rate of morbidity, and is highly efficacious. The use of invasive presurgical investigation (SEEG) may explain this high rate of success.
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Affiliation(s)
- M Sindou
- Department of Functional Neurosurgery, Federative Institute of Neurosciences, Neurological Hospital P. Wertheimer, Lyon, France.
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Rosenberg DS, Demarquay G, Jouvet A, Le Bars D, Streichenberger N, Sindou M, Kopp N, Mauguière F, Ryvlin P. [11C]-Methionine PET: dysembryoplastic neuroepithelial tumours compared with other epileptogenic brain neoplasms. J Neurol Neurosurg Psychiatry 2005; 76:1686-92. [PMID: 16291894 PMCID: PMC1739454 DOI: 10.1136/jnnp.2004.051607] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND AND OBJECTIVES Brain tumours responsible for longstanding partial epilepsy are characterised by a high prevalence of dysembryoplastic neuroepithelial tumour (DNT), whose natural evolution is much more benign than that of gliomas. The preoperative diagnosis of DNT, which is not yet feasible on the basis of available clinical and imaging data, would help optimise the therapeutic strategy for this type of tumour. This study tested whether [(11)C]-methionine positron emission tomography (MET-PET) could help to distinguish DNTs from other epileptogenic brain tumours. METHODS Prospective study of 27 patients with partial epilepsy of at least six months duration related to a non-rapidly progressing brain tumour on magnetic resonance imaging (MRI). A structured visual analysis, which distinguished between normal, moderately abnormal, or markedly abnormal tumour methionine uptake, as well as various regions of interest and semiquantitative measurements were conducted. RESULTS Pathological results showed 11 DNTs (41%), 5 gangliogliomas (18%), and 11 gliomas (41%). MET-PET visual findings significantly differed between the various tumour types (p<0.0002), regardless of gadolinium enhancement on MRI, and were confirmed by semiquantitative analysis (p<0.001 for all calculated ratios). All gliomas and gangliogliomas were associated with moderately or markedly increased tumour methionine uptake, whereas 7/11 DNTs had a normal methionine uptake, including all six located in the mesiotemporal structures. No DNT presented with a marked MET-PET abnormality. CONCLUSION Normal MET-PET findings in patient with an epileptogenic and non-rapidly progressing brain tumour are suggestive of DNT, whereas a markedly increased tumour methionine uptake makes this diagnosis unlikely.
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Affiliation(s)
- D S Rosenberg
- Cermep, Hopital Neurologique, 59 Bd Pinel, Lyon 69003, France
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Barba C, Valeriani M, Colicchio G, Mauguière F. Short and middle-latency Median Nerve (MN) SEPs recorded by depth electrodes in human pre-SMA and SMA-proper. Clin Neurophysiol 2005; 116:2664-74. [PMID: 16221571 DOI: 10.1016/j.clinph.2005.07.022] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2005] [Revised: 07/25/2005] [Accepted: 07/29/2005] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To analyse waveforms, latencies and amplitudes of Median Nerve (MN) SEPs recorded by stereotactically electrodes implanted in the SMA of 14 epileptic patients (9 in pre-SMA,3 in SMA-proper, 2 in both) in order to evaluate which short and middle-latency SEPs are generated in this area and which could be the physiological relevance of these responses. METHODS Short and middle-latency MN SEPs were recorded by chronically implanted electrodes in the fronto-temporal cortex and in particular in the mesial frontal region of 14 drug-resistant epileptic patients. MN stimulations of 100 micros were delivered by skin electrodes at the wrist; stimulus intensity was adjusted slightly above the motor threshold. RESULTS The main result of this study is that middle-latency SEPs were originated in pre-SMA but not in SMA-proper as demonstrated by both referential and bipolar recordings. In particular off-line computed bipolar traces between neighbouring contacts implanted in the pre-SMA and in the frontal external regions showed a phase reversal at the deepest contacts located in pre-SMA. Conversely, bipolar recordings between neighbouring contacts implanted in the SMA-proper and in the frontal external regions showed inversion recovery at more superficial contacts, implanted in area 6. Finally, we confirmed that no short-latency MN SEP (and in particular the N30) is originated in the whole SMA. CONCLUSIONS Among premotor areas, somatosensory inputs seem to reach pre-SMA and area 6 but not SMA-proper. SIGNIFICANCE This study assessed that no scalp SEP in the first 100 ms after MN stimulus could be generated in SMA-proper.
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Affiliation(s)
- C Barba
- Fondazione Santa Lucia, IRCCS, Rome, Italy.
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Mazzola L, Isnard J, Mauguière F. Somatosensory and pain responses to stimulation of the second somatosensory area (SII) in humans. A comparison with SI and insular responses. ACTA ACUST UNITED AC 2005; 16:960-8. [PMID: 16177270 DOI: 10.1093/cercor/bhj038] [Citation(s) in RCA: 123] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Somatosensory and pain responses to direct intracerebral stimulations of the SII area were obtained in 14 patients referred for epilepsy surgery. Stimulations were delivered using transopercular electrodes exploring the parietal opercular cortex (SII area), the suprasylvian parietal cortex (SI area) and the insular cortex. SII responses were compared to those from adjacent SI and insular cortex. In the three areas we elicited mostly somatosensory responses, including paresthesiae, temperature and pain sensations. The rate of painful sensations (10%) was similar in SII and in the insula, while no painful sensation was evoked in SI. A few non-somatosensory responses were evoked by SII stimulation. Conversely various types of non-somatosensory responses (auditory, vegetative, vestibular, olfacto-gustatory, etc.) were evoked only by insular stimulation, confirming that SII, like SI, are mostly devoted to the processing of somatosensory inputs whereas the insular cortex is a polymodal area. We also found differences in size and lateralization of skin projection fields of evoked sensations between the three studied areas, showing a spatial resolution of the somatotopic map in SII intermediate between those found in SI and insula. This study shows the existence of three distinct somatosensory maps in the suprasylvian, opercular and insular regions, and separate pain representations in SII and insular cortex.
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Affiliation(s)
- L Mazzola
- Department of Functional Neurology and Epileptology, Federative Institute of Neurosciences, Hôpital Neurologique, Lyon, France
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Catenoix H, Magnin M, Guénot M, Isnard J, Mauguière F, Ryvlin P. Hippocampal-orbitofrontal connectivity in human: an electrical stimulation study. Clin Neurophysiol 2005; 116:1779-84. [PMID: 16002335 DOI: 10.1016/j.clinph.2005.03.016] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2004] [Revised: 03/01/2005] [Accepted: 03/25/2005] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The identification of the pathways involved in seizure propagation remains poorly understood in humans. For instance, the respective role of the orbitofrontal cortex (OFC) and of the commissural pathways in the interhemispheric propagation of mesial temporal lobe seizures (mTLS) is a matter of debate. In order to address this issue, we have directly tested the functional connectivity between the hippocampus and the OFC in 3 epileptic patients undergoing an intra-cranial stereotactic EEG investigation. METHODS Bipolar electrical stimulations, consisting of two series of 25 pulses of 1 ms duration, 0.2 Hz frequency, and 3 mA intensity, were delivered in the hippocampus. Evoked potentials (EPs) were analysed for each series, separately. Grand average of reproducible EPs was then used to calculate latency of the first peak of each individual potential. RESULTS Hippocampal stimulations evoked reproducible responses in the OFC in all 3 patients, with a mean latency of the first peak of 222 ms (range: 185-258 ms). CONCLUSIONS Our data confirm a functional connectivity between the hippocampus and the OFC in human. SIGNIFICANCE This connectivity supports the potential role of the OFC in the propagation of mTLS.
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Affiliation(s)
- H Catenoix
- Department of Functional Neurology and Epileptology, Neurological Hospital, Lyon, France
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Abstract
The authors studied the relation between seizure-associated nose wiping (NW) and intracerebral EEG data in 32 patients. NW was more frequent in mesial temporal lobe seizures (TLSs; 65%) than in other TLSs (36%; p < 0.05) and in frontal lobe seizures (3%; p < 0.0001). It was associated with the presence of an amygdala discharge at seizure onset (p < 0.05) and with the recording of an ictal low-voltage fast activity within that structure (p < 0.05), supporting the role of an amygdala dysfunction in the pathophysiology of NW.
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Affiliation(s)
- H Catenoix
- Department of Functional Neurology and Epileptology, Neurological Hospital, Lyon, France
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Durand-Dubief F, Ryvlin P, Mauguière F. [Polymorphism of epilepsy associated with the A3243G mutation of mitochondrial DNA (MELAS): reasons for delayed diagnosis]. Rev Neurol (Paris) 2005; 160:824-9. [PMID: 15454870 DOI: 10.1016/s0035-3787(04)71038-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Mitochondrial disease is a potential diagnosis in patients with epilepsy beginning in childhood or adolescence with a typical polymorphic presentation and preponderant occipital lobe seizures. Diagnosis may however be delayed in some patients with long-standing disease, particularly when cardinal mitochondrial symptoms are missing; clinical manifestations may be dissociated over time leading to genetic diagnostic tests being prescribed long after disease onset. OBSERVATION We report the case of a 17 year old woman in whom the diagnosis of lipothymic episodes, migraine, idiopathic photo-sensitive generalized epilepsy, and partial occipital epilepsy complicated by occipital epileptic status were successively proposed because of the initial clinical presentation and the slow disease course. Eleven years after disease onset the diagnosis of progressive myoclonic epilepsy was made due to the occurrence of myoclonic jerks with giant SEPs associated with a cerebellar syndrome, deterioration of psychomotor performances and diffuse slowing of EEG activity with pseudo-periodic bursts of delta waves. Genetic analysis showed an A3243G mutation of mitochondrial DNA, usually correlated with the MELAS phenotype, while the clinical presentation of progressive myoclonic epilepsy was more suggestive of MERRF. CONCLUSION Although each of the symptoms successively observed in this patient has been reported in MELAS, the slow course of the disease, which is unusual in this mutation, the absence of stroke-like episodes, and the polymorphism of the epilepsy all contributed to delayed final diagnosis.
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Affiliation(s)
- F Durand-Dubief
- Service de Neurologie A, Hôpital Neurologique Pierre Wertheimer, Lyon
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Abstract
The role of the insular lobe in temporal lobe epilepsy (TLE) has often been suggested but never directly demonstrated. In this article, we review data from recent literature and from our stereo-electroencephalographic (SEEG) recordings in patients referred for temporal lobe epilepsy surgery (TLE). Our description of the clinical features of insular lobe seizures is based on data from video and SEEG ictal recordings and direct electric cortical stimulation in a population of 50 consecutive patients whose seizures, on the basis of scalp video EEG recordings, were suspected to originate from, or to rapidly propagate to, the peri-sylvian cortex. A total of 144 intra-insular electrodes have been implanted in this series of patients. In six patients a stereotyped sequence of ictal symptoms could be identified on the basis of electro-clinical correlations. The clinical presentation of insular lobe seizures was that of simple partial seizures occurring in full consciousness, beginning with a sensation of laryngeal constriction followed by paresthesiae that were often unpleasant affecting large cutaneous territories. These initial symptoms were eventually followed by dysarthric speech and/or elementary auditory hallucinations, and seizures often ended with focal dystonic postures. The insular origin of these symptoms was supported by the data from functional cortical mapping of the insula using direct cortical stimulations. We were able to reproduce several of the spontaneous ictal symptoms in the six patients with insular seizures. Moreover, from the whole set of insular stimulations that we performed it could be concluded that the insular cortex is involved in somatic, vegetative and visceral functions to which spontaneous ictal insular symptoms are related. The observation of the insular symptoms sequence at the onset of seizures in patients who are candidates for TLE surgery strongly suggests that the epileptic focus is located in the insular lobe. It entails the risk of unsuccessful temporal lobectomy and should lead: i) to reconsider the indication of temporal lobectomy and; ii) to explore directly the ictal activity of both mesio-temporal and insular cortices before making any decision regarding epilepsy surgery.
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Affiliation(s)
- J Isnard
- Unité de Neurologie Fonctionnelle et d'Epileptologie, Hôpital Neurologique, Lyon.
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Ryvlin P, Mauguière F. L’imagerie fonctionnelle chez l’adulte. Rev Neurol (Paris) 2004. [DOI: 10.1016/s0035-3787(04)71190-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Mauguière F. Les épilepsies partielles pharmaco-résistantes : Réflexions introductives sur leur classification, leur physiopathologie et leur traitement neurochirurgical. Rev Neurol (Paris) 2004. [DOI: 10.1016/s0035-3787(04)71176-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Mauguière F. [Drug-resistant partial epilepsies: introductory remarks on their classification, pathophysiology and surgical treatment]. Rev Neurol (Paris) 2004; 160 Spec No 1:5S11-20. [PMID: 15331943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
There is no validated classification of drug-resistant partial epilepsies in adults that have proved helpful to individualize homogeneous groups of patients, whose clinical course would be predictable at the early stage of the disease and whose treatment, eventually surgical, could be standardized. The only entity fitting with this definition is the syndrome of mesio-temporal lobe epilepsy, which accounts for a high percentage of surgical treatment indications. However the objective to perform surgical treatment in all of these patients is far from being reached in France, as in many other developed countries. Apart from this syndrome, therapeutic decisions are mostly based on case by case clinical and electrophysiological analysis of seizures, in relation with the localization and anatomy of the causal lesion, when the latter can be identified using brain MRI. The pragmatic approach consists in aiming at a consensus regarding the nature and the reliability of presurgical strategies, including invasive electrophysiological investigations, rather than in elaborating a syndromic classification, the pertinence of which cannot be validated. Some concepts and data that might be helpful to reach a consensus are discussed in this brief review article.
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Affiliation(s)
- F Mauguière
- Service de Neurologie Fonctionnelle et d'Epileptologie & IFR des Neurosciences de Lyon, Hôpital Neurologique, 59 boulevard Pinel, 69003 Lyon, France.
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Ryvlin P, Mauguière F. [Functional neuroimaging in adults]. Rev Neurol (Paris) 2004; 160 Spec No 1:5S117-30. [PMID: 15331957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
A consensus has not been reached on the proper role of the different functional neuroimaging techniques available for the exploration of drug-resistant partial epilepsy, particularly in preparation for surgery. Several studies have suggested the potential contribution of positron emission tomography (PET) with [18F]-fluoro-deoxyglucose (FDG), [11C]-flumazenil (FMZ), or [11C]-alpha-methyl-tryptophane (AMT), single-photon emission computed tomography (SPECT) to measure ictal cerebral blood flow, magnetic resonance spectroscopy (MRS), and functional magnetic resonance imaging (fMRI) of language and memory functions, but to date there has been no impact study validating the clinical contribution of these different exploration techniques. The most robust data in the literature indicate that [18F]-FDG PET can help to predict surgical failures in patients with temporal lobe epilepsy. Studies with lesser power have suggested that SPECT measurement of ictal hyperperfusion blood flow, and [11C]-FMZ and [11C]-AMT PET can be useful in symptomatic neocortical epilepsy, particularly in patients with tuberous sclerosis explored with [11C]-AMT PET. Use of these different exploration techniques in epileptic patients with a normal MRI is warranted when complementary information could help in deciding on when and how to perform an invasive EEG, but there are significant risks of erroneous identification of the epileptogenic zone. Functional MRI assessment of language regions can be proposed as an alternative to the Wada test to determine hemispheric dominance in patients with temporal lobe epilepsy. Multicentric impact studies will be needed before evidence-based guidelines can be developed for the use of functional neuroimaging techniques in drug-resistant partial epilepsy.
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MESH Headings
- Adult
- Anterior Temporal Lobectomy
- Anticonvulsants/therapeutic use
- Carbon Radioisotopes
- Combined Modality Therapy
- Dominance, Cerebral
- Drug Resistance
- Epilepsies, Partial/diagnosis
- Epilepsies, Partial/diagnostic imaging
- Epilepsies, Partial/drug therapy
- Epilepsies, Partial/pathology
- Epilepsies, Partial/surgery
- Epilepsy, Temporal Lobe/diagnosis
- Epilepsy, Temporal Lobe/diagnostic imaging
- Epilepsy, Temporal Lobe/drug therapy
- Epilepsy, Temporal Lobe/pathology
- Epilepsy, Temporal Lobe/surgery
- Flumazenil
- Fluorodeoxyglucose F18
- Humans
- Language Tests
- Magnetic Resonance Imaging
- Magnetic Resonance Spectroscopy
- Memory Disorders/prevention & control
- Preoperative Care
- Radiopharmaceuticals
- Temporal Lobe/diagnostic imaging
- Temporal Lobe/physiopathology
- Tomography, Emission-Computed
- Tomography, Emission-Computed, Single-Photon
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Affiliation(s)
- P Ryvlin
- Service de Neurologie Fonctionnelle et d'Epileptologie, Hôpital Neurologique, 59 boulevard Pinel, 69000 Lyon, France.
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Logi F, Fischer C, Murri L, Mauguière F. The prognostic value of evoked responses from primary somatosensory and auditory cortex in comatose patients. Clin Neurophysiol 2003; 114:1615-27. [PMID: 12948790 DOI: 10.1016/s1388-2457(03)00086-5] [Citation(s) in RCA: 104] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate somatosensory and auditory primary cortices using somatosensory evoked potentials (SEPs) and middle latency auditory evoked potentials (MLAEPs) in the prognosis of return to consciousness in comatose patients. METHODS SEPs and MLAEPs were recorded in 131 severe comatose patients. Latencies and amplitudes were measured. Coma had been caused by transient cardiac arrest (n=49), traumatic brain injury (n=22), stroke (n=45), complications of neurosurgery (n=12) and encephalitis (n=3). One month after the onset of coma patients were classified as awake, still comatose or dead. Three months after (M3), they were classified into one of the 5 categories of the Glasgow outcome scale (GOS). RESULTS At M3, 41.2% were dead, 47.3% were conscious (GOS 3-5) and 11.5% had not recovered consciousness. None of the patients in whom somatosensory N20 and auditory Pa were absent did return to consciousness and in the post-anoxic group, reduced cortical amplitude too was always associated with bad outcome. Conversely, N20 and Pa were present, respectively, in 33/69 and 34/69 patients who did not recover. CONCLUSIONS The prognostic value of SEPs and MLAEPs in comatose patients depends on the cause of coma. Measurement of response amplitudes is informative. Abolition of cortical SEPs and/or cortical MLAEPs precludes post-anoxic comatose patients from returning to consciousness (100% specificity). In any case, the presence of short latency cortical somatosensory or auditory components is not a guarantee for return to consciousness. Late components should then be recorded.
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Affiliation(s)
- F Logi
- Neurologie Fonctionnelle and EA1880, Hôpital Neurologique, 59, Boulevard Pinel, 69003 Lyon, France
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Barba C, Valeriani M, Restuccia D, Colicchio G, Faraca G, Tonali P, Mauguière F. The human supplementary motor area-proper does not receive direct somatosensory inputs from the periphery: data from stereotactic depth somatosensory evoked potential recordings. Neurosci Lett 2003; 344:161-4. [PMID: 12812830 DOI: 10.1016/s0304-3940(03)00378-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Somatosensory evoked potentials to median nerve (MN) stimulation were recorded by stereotactically implanted electrodes in the frontal lobe of two epileptic patients in order to evaluate whether short-latency cortical responses could be generated in the supplementary motor area (SMA)-proper. In both patients two potentials, called P20 and N30 responses, showed a decreasing amplitude from the most superficial to the deepest contacts and were recorded in the white as well in the grey matter of the frontal lobe. Furthermore, no phase reversal of both P20 and N30 potentials was identifiable along electrode trajectories. Our results suggest that short-latency somatosensory evoked responses recorded in the SMA-proper contralateral to MN stimulation are volume conducted from remote cortical generators.
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Affiliation(s)
- C Barba
- Department of Neurology, Catholic University, Rome, Italy.
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Nové-Josserand A, André-Obadia N, Mauguière F. [Cervical spondylotic myelopathy: motor and somatosensory evoked potentials, clinical and radiological correlation]. Rev Neurol (Paris) 2002; 158:1191-7. [PMID: 12690738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
Somatosensory and motor evoked potentials (EPs) have been recorded in 38 patients with cervical spondylosis, documented by MRI. All were symptomatic, 23 presented with myelopathy. Somatosensory evoked potentials were abnormal in 66p.cent as well as motor evoked potentials. The N13 potential, generated by the posterior dorsal horn of the cervical spinal cord, was abnormal in 63p.cent of patients and was the only disorder detected in 12p.cent. Together, somatosensory and motor evoked potentials were abnormal in 82p.cent of patients. There was no correlation between EPs findings and radiological data. Similary, MRI and clinical data were agreeing in only 50p.cent of patients. When a spondylotic myelopathy is suspected, SEPs proved more sensitive to detect somatosensory dysfunctionning than clinical testing and radiological data were discordant with clinical status in 50p.cent of cases. In order to obtain a high sensitivity, both somatosensory and motor evoked potentials should be recorded on all limbs with a special attention to segmental cervical and cervico-medullary responses. EPs data help to identify patients with cervical cord dysfunction and thus contribute to the therapeutic decision for surgery.
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Affiliation(s)
- A Nové-Josserand
- Service de Neurologie Fonctionnelle et d'Epileptologie, Hôpital Neurologique et Neurochirurgical Pierre Wertheimer, 59, boulevard Pinel, 69394 Lyon.
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Nové-Josserand A, André-Obadia N, Mauguière F. [Cervical spondylotic myelopathy: motor and somatosensory evoked potentials, clinical and radiological correlations]. Rev Neurol (Paris) 2002; 158:1191-7. [PMID: 12500140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Affiliation(s)
- A Nové-Josserand
- Service de Neurologie Fonctionnelle et d'Epileptologie, Hôpital Neurologique, Lyon
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Abstract
OBJECTIVE To record somatosensory evoked potentials (SEPs) to median nerve stimulation by chronically implanted electrodes in the parieto-rolandic opercular area of 9 epileptic patients, in order to evaluate whether somatosensory evoked responses could be generated in the second somatosensory area (SII) earlier than 40 ms after stimulus. METHODS Nine patients (4 males, 5 females) with drug-resistant partial epileptic seizures were investigated using stereotactically implanted electrodes in the parietal cortex, posterior to vertical anterior commissure plane and in the frontal opercular region rostral to vertical anterior commissure (VAC). RESULTS The main finding of this study is the recording of an early somatosensory evoked potential, (N30op), by chronically implanted electrodes in the SII area of 8 epileptic patients. In 3 patients where SEPs were performed after ipsilateral median nerve (MN) stimulation, a N30op was recorded 5.8+/-2 ms later than contralateral one. CONCLUSIONS This is the first report of early SEPs recorded by electrodes implanted in SII area. The N30op potential, even if less consistent than later potentials, confirmed the important role of the SII area in the early processing of somatosensory inputs.
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Affiliation(s)
- Carmen Barba
- Department of Neurology, Catholic University, Largo A. Gemelli 8, 00168 Rome, Italy.
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Peyron R, Frot M, Schneider F, Garcia-Larrea L, Mertens P, Barral FG, Sindou M, Laurent B, Mauguière F. Role of operculoinsular cortices in human pain processing: converging evidence from PET, fMRI, dipole modeling, and intracerebral recordings of evoked potentials. Neuroimage 2002; 17:1336-46. [PMID: 12414273 DOI: 10.1006/nimg.2002.1315] [Citation(s) in RCA: 171] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Insular and SII cortices have been consistently shown by PET, fMRI, EPs, and MEG techniques to be activated bilaterally by a nociceptive stimulation. The aim of the present study was to refer to, and to compare within a common stereotactic space, the nociceptive responses obtained in humans by (i) PET, (ii) fMRI, (iii) dipole modeling of scalp LEPs, and (iv) intracerebral recordings of LEPs. PET, fMRI, and scalp LEPs were obtained from normal subjects during thermal pain. Operculoinsular LEPs were obtained from 13 patients using deep brain electrodes implanted for presurgical evaluation of drug-resistant epilepsy. Whatever the technique, we obtained responses which were located bilaterally in the insular and SII cortices. In electrophysiological responses (LEPs) the SII insular contribution peaked between 150 and 250 ms poststimulus and corresponded to the earliest portions of the whole cerebral response. Group analysis of PET and fMRI data showed highly consistent responses contralateral to stimulation. On single-subject analysis, LEPs and fMRI activations were concentrated in relatively restricted volumes even though spatial sampling was quite different for both techniques. Despite our multimodal approach, however, it was not possible to separate insular from SII activities. Individual variations in the anatomy and function of SII and insular cortices may explain this limitation. This multimodal study provides, however, cross-validated spatial and temporal information on the pain-related processes occurring in the operculoinsular region, which thus appears as a major site for the early cortical pain encoding in the human brain.
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Affiliation(s)
- R Peyron
- Clinical Neurophysiology and Epileptology Department, Lyon, France.
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Montes C, Mertens P, Convers P, Peyron R, Sindou M, Laurent B, Mauguière F, Garcia-Larrea L. Cognitive effects of precentral cortical stimulation for pain control: an ERP study. Neurophysiol Clin 2002; 32:313-25. [PMID: 12490329 DOI: 10.1016/s0987-7053(02)00340-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Electrical stimulation of the motor cortex (MCS) is a promising and increasingly used neurosurgical technique for the control of refractory neuropathic pain. Although its mechanisms of action remain unknown, recent functional imaging data suggest involvement of the thalamus, brainstem and anterior cingulate/orbitofrontal cortex. Since some of these areas are also implicated in higher cognitive functions, notably attentional processes, we analysed cognitive ERPs and behavioural performance during an "oddball" auditory detection task in patients submitted to this procedure. Eleven consecutive patients undergoing MCS because of neuropathic refractory pain, ranging in age from 25 to 71 years, were included in the study. ERPs were obtained in all cases both during the application ("MCS-on") and within the 10 min that followed discontinuation of the procedure ("MCS-off"). In five patients, ERPs could also be obtained just before the start of MCS. When the patients' sample was taken as a whole, there were no consistent effects of MCS on the ERPs. There was, however, a significant interaction of MCS action with the patients' age, reflecting a significant delay during MCS of the cognitive responses N2 and P3 (N200 and P300) in the group of patients older than 50 years exclusively. This effect was rapidly reversible after MCS discontinuation. No MCS-related changes were observed in the N1 component. At the individual level, the effect of MCS on the endogenous ERPs was highly variable, ranging from a total stability of ERPs (mostly in younger subjects) to latency differences of tens of milliseconds in the older group. These results, together with recent experiments showing P300 alteration during repetitive transcranial stimulation, suggest that motor cortex stimulation may interfere with relatively simple cognitive processes such as those underlying target detection, and that the risk of abnormal cognitive effects related to cortical stimulation may increase with age. Although the procedure appears on the whole remarkably safe, complementary neuropsychological studies in this category of patients are advised, as well as caution to possible adverse cognitive effects when using MCS in the elderly, notably in the presence of pre-existent cerebral lesions.
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Affiliation(s)
- C Montes
- Equipe d'accueil, EA1880 UCB, Lyon, France
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