TY - JOUR
T1 - Subacute neocortical stimulation (SNCS) and its effects on epileptic activity in adults and children diagnosed with focal cortical dysplasia (FCD)
AU - Freigang, Sascha
AU - Jiménez-Jiménez, Diego
AU - Kazi, Farhana
AU - Díaz-Díaz, Judit
AU - Pina, Marisa
AU - Cunha, Maria
AU - Alarcón, Gonzalo
AU - Selway, Richard P.
AU - Valentín, Antonio
PY - 2020/10
Y1 - 2020/10
N2 - Background: Chronic intracranial electrical stimulation is now widely used as treatment for drug resistant epilepsy. Subacute neocortical stimulation (SNCS) can also be performed during EEG recordings with intracranial electrodes (iEEG), but its diagnostic value remains largely unknown. Methods: We assessed the effects of SNCS on the frequency of seizures and epileptiform discharges (EDs) during 290 h of iEEG- from 12 patients (6 adults, 6 children) with epilepsy secondary to focal cortical dysplasia (FCD). Results: In 9/12 patients, SNCS periods showed decreased seizure-frequency (Median -73 %, p = 0.0093). At baseline, incidence of EDs were correlated with seizure-frequency (Spearman r = 0.59). However, this correlation disappeared during SNCS and a significant change in the incidence of EDs was observed. In addition, there was a trend towards greater reduction in seizure-frequency during SNCS in patients who underwent surgery. Conclusion: In summary, SNCS can reduce seizure-frequency and changes ED-frequency. The variability in ED changes may be explained by different effects of SNCS depending on electrode location. The magnitude of seizure reduction during SNCS suggests that this technique could contribute to preoperative assessment in epilepsy surgery.
AB - Background: Chronic intracranial electrical stimulation is now widely used as treatment for drug resistant epilepsy. Subacute neocortical stimulation (SNCS) can also be performed during EEG recordings with intracranial electrodes (iEEG), but its diagnostic value remains largely unknown. Methods: We assessed the effects of SNCS on the frequency of seizures and epileptiform discharges (EDs) during 290 h of iEEG- from 12 patients (6 adults, 6 children) with epilepsy secondary to focal cortical dysplasia (FCD). Results: In 9/12 patients, SNCS periods showed decreased seizure-frequency (Median -73 %, p = 0.0093). At baseline, incidence of EDs were correlated with seizure-frequency (Spearman r = 0.59). However, this correlation disappeared during SNCS and a significant change in the incidence of EDs was observed. In addition, there was a trend towards greater reduction in seizure-frequency during SNCS in patients who underwent surgery. Conclusion: In summary, SNCS can reduce seizure-frequency and changes ED-frequency. The variability in ED changes may be explained by different effects of SNCS depending on electrode location. The magnitude of seizure reduction during SNCS suggests that this technique could contribute to preoperative assessment in epilepsy surgery.
KW - Cortical stimulation
KW - Epilepsy surgery
KW - Epileptiform discharges
KW - intracranial EEG
KW - Neuromodulation
UR - http://www.scopus.com/inward/record.url?scp=85087993969&partnerID=8YFLogxK
U2 - 10.1016/j.eplepsyres.2020.106392
DO - 10.1016/j.eplepsyres.2020.106392
M3 - Article
AN - SCOPUS:85087993969
SN - 0920-1211
VL - 166
JO - Epilepsy Research
JF - Epilepsy Research
M1 - 106392
ER -