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Temporolimbic Activation by Intracranial Electrical Stimulation

Published online by Cambridge University Press:  02 December 2014

Jorge A. Ure ,
André Olivier ,
Luis Felipe Quesney ,
Mauricio Bravo  and
Mónica Perassolo
Jorge A. Ure*
Affiliation:
Department of Neurology, Borda and Moyano Hospitals, Buenos Aires, Argentina
André Olivier
Affiliation:
Department of Neurosurgery, Montreal Neurological Institute and Hospital, Montréal PQ, Canada
Luis Felipe Quesney
Affiliation:
Department of Electroencephalography, Montreal Neurological Institute and Hospital, Montréal PQ, Canada
Mauricio Bravo
Affiliation:
Department of Electroencephalography, Montreal Neurological Institute and Hospital, Montréal PQ, Canada
Mónica Perassolo
Affiliation:
Department of Neurology, Borda and Moyano Hospitals, Buenos Aires, Argentina
*
Department of Neurology, Borda Hospital, Ramón Carrillo 375, Buenos Aires, Argentina
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Abstract

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Background:

To evaluate the results of intracranial electrical stimulation (ICES) as a pre-surgical tool in order to select the side of the operation in bitemporal lobe epilepsy (BTLE) patients who underwent depth electrode (DE) implantation.

Methods:

We reviewed the files of 77 medically intractable BTLE patients who underwent ICES with positive results through implanted DEs and then were under surgical treatment. One year or more after surgery, we evaluated the outcome. ICES was performed through: 1) Square-wave bipolar stimulation with symmetrical pulses of 60 Hz for 0.5 ms was delivered by a constant current Nuclear Chicago stimulator; 2) An initial intensity of 0.5 mA, and subsequently progressively stronger currents at 1-2 and occasionally 3 or 4 mA; 3) The duration of a single stimulation was usually 5 seconds; 4) The volume of tissue effectively stimulated did not exceed 5 mm.

Results:

We obtained habitual auras or seizures (clinical responses, CRs) in 74 patients and after-discharges, ADs in 61 of them, according to Engel's classification for post surgery outcomes. If CRs or ADs were obtained by stimulation of only one temporal lobe the result of epilepsy surgery tended to be better (Engel classes I or II) when the operation was done on the same side of positive CRs (15 cases) or ADs (14 cases), and tended to be worse (Engel classes III or IV) when the ICES had provoked bilateral responses or when the side operated on was contra-lateral to positive CRs (33 cases) or ADs (28 cases). Statistical analyses were performed in order to test these results and we found better post-operative results when the resection took place in the same side of positive responses to ICES (CRs: χ2 4.74 and p=0.0295; ADs: χ2 7.57 and p=0.0059).

Conclusion:

In addition to other methods (PET, MRI and neuropsychology) presurgical ICES can provide useful data in the process of identifying the temporal lobe to be targeted for resection in BTLE patients.

Type
Original Article
Information
Canadian Journal of Neurological Sciences , Volume 36 , Issue 5 , September 2009 , pp. 593 - 598
Copyright
Copyright © The Canadian Journal of Neurological 2009

References

1.Gombi, R, Velok, G, Hullay, J.The value of electrostimulation in epileptic focus localization. Acta Neurochir (Wien). 1976;23 Suppl:15–20.Google Scholar
2.Engel, J Jr. Outcome with respect to epileptic seizures. In: Engel, J Jr, editor. Surgical treatment of the epilepsies. New York: Raven Press; 1987. p. 553–71.Google Scholar
3.Quesney, LF, Gloor, P.Localization of epileptic foci. Electroencephalogr Clin Neurophysiol Suppl. 1985;37:165–200.Google Scholar
4.Fish, DR, Gloor, P, Quesney, LF, Olivier, A.Clinical responses to electrical brain stimulation of the temporal and frontal lobes in patients with epilepsy. Pathophysiological implications. Brain. 1993;116(2):397–414.Google ScholarPubMed
5.Olivier, A, de Lotbinière, A.Stereotactic techniques in epilepsy. In: Tasker, RR, editor. Stereotactic surgery. Neurosurgery: state of the arts reviews, Vol 2, No. 1. Philadelphia: Hanley and Belfus; 1987. p. 257–85.Google Scholar
6.Olivier, A, Marchand, E, Peters, T, Tyler, J.Depth electrode implantation at the Montreal Neurological Institute and Hospital. In: Engel, J Jr, editor. Surgical treatment of the epilepsies. New York: Raven Press; 1987. p. 595–601.Google Scholar
7.Gloor, P, Olivier, A, Quesney, LF, Andermann, F, Horowitz, S.The role of the limbic system in experiential phenomena of temporal lobe epilepsy. Ann Neurol. 1982;12(2):129–44.CrossRefGoogle ScholarPubMed
8.Ives, JR, Gloor, P.A long term time-lapse video system to document the patient’s spontaneous clinical seizure synchronized with the EEG. Electroencephalogr Clin Neurophysiol. 1978;45(3): 412–16.Google Scholar
9.Gotman, J, Ives, JR, Gloor, P, Quesney, LF, Bergsma, P.Monitoring at the Montreal Neurological Institute. Electroencephalogr Clin Neurophysiol Suppl. 1985;37:327–40.Google ScholarPubMed
10.Feindel, W.Response patterns elicited from the amygdala and deep temporoinsular cortex. In: Sheer, D, editor. Electrical stimulation of the brain: an interdisciplinary survey of neurobehavioral integrative systems. Austin, TX: University of Texas Press; 1961. p. 519–32.Google Scholar
11.Palmini, A, Gloor, P.The localizing value of auras in partial seizures: a prospective and retrospective study. Neurology. 1992;42(4): 801–8.Google Scholar
12.Salanova, V, Andermann, F, Rasmussen, T, Olivier, A, Quesney, L.The running down phenomenon in temporal lobe epilepsy. Brain. 1996;119(3):989–96.Google Scholar
13.Mickle, WA.The problems of stimulation parameters. In: Sheer, D, editor. Electrical stimulation of the brain: an interdisciplinary survey of neurobehavioral integrative systems. Austin, TX: University of Texas Press; 1961. p. 67–73.Google Scholar
14.So, N, Gloor, P, Quesney, LF, Jones-Gotman, M, Olivier, A, Andermann, F.Depth electrode investigations in patients with bitemporal epileptiform abnormalities. Ann Neurol. 1989;25(5):423–31.CrossRefGoogle ScholarPubMed
15.Bernier, GP, Richer, F, Giard, N, Bouvier, G, Mercier, M, Turmel, A, et al.Electrical stimulation of the human brain in epilepsy. Epilepsia. 1990;31(5):513–20.Google Scholar
16.Kahane, P, Tassi, L, Francione, S, Hoffmann, D, Lo Russo, G, Munari, C.[Electroclinical manifestations elicited by intracerebral electrical stimulation “shocks” in temporal lobe epilepsy]. Neurophysiol Clin. 1993;23(4):305–26. French.Google Scholar
17.Valentin, A, Anderson, M, Alarcón, G, Seoane, JJ, Selway, R, Binnie, CD, et al.Responses to single pulse electrical stimulation identify epileptogenesis in the human brain in vivo. Brain. 2002;125(8):1709–18.Google Scholar
18.Valentin, A, Alarcón, G, Garcia-Seoane, JJ, Lacruz, ME, Nayak, SD, Honavar, M, et al.Single-pulse electrical stimulation identifies epileptogenic frontal cortex in the human brain. Neurology. 2005;65(3):426–35.Google Scholar
19.Valentin, A, Alarcón, G, Honavar, M, Garcia-Seoane, JJ, Selway, RP, Polkey, CE, et al.Single pulse electrical stimulation for identification of structural abnormalities and prediction of seizure outcome after epilepsy surgery: a prospective study. Lancet Neurol. 2005;4(11):718–26.Google Scholar
20.Bancaud, J, Brunet-Bourgin, F, Chauvel, P, Halgren, E.Anatomical origin of déjà vu and vivid ‘memories’ in human temporal lobe epilepsy. Brain. 1994;117(1):71–90.Google Scholar
21.Halgren, E, Walker, RD, Cherlow, DG, Crandall, PH.Mental phenomena evoked by electrical stimulation of the human hippocampal formation and amygdala. Brain. 1978;101(1): 83–117.CrossRefGoogle ScholarPubMed
22.Ishibashi, T, Hon, H, Endo, K, Sato, T.Hallucinations produced by electrical stimulation of the temporal lobes in schizophrenic patients. Tohoku J Exp Med. 1964;82:124–39.CrossRefGoogle ScholarPubMed
23.Schulz, R, Luders, HO, Tuxhorn, I, Ebner, A, Holthausen, H, Hoppe, M, et al.Localization of epileptic auras induced on stimulation by subdural electrodes. Epilepsia. 1997;38(12):1321–9.Google Scholar
24.So, N, Olivier, A, Andermann, F, Gloor, P, Quesney, LF.Results of surgical treatment in patients with bitemporal epileptiform abnormalities. Ann Neurol. 1989;25(5):432–9.Google Scholar
25.Benbadis, S, So, N, Antar, MA, Barnett, GH, Morris, HH.The value of PET scan (and MRI and Wada Test) in patients with bitemporal epileptiform abnormalities. Arch Neurol. 1995;52(11):1062–8.Google Scholar
26.Halgren, E, Marinkovic, K.Neurophysiological networks integrating human emotions. In: Gazzaniga, MS, editor. The Cognitive Neurosciences. Cambridge, MA: MIT Press; 1994. p. 1137–51.Google Scholar
27.Penfield, W.The mystery of the mind. A critical study of consciousness and the human brain. Princeton, NJ: Princeton University Press; 1975.Google Scholar
28.Halgren, E, Chauvel, P.Experiential phenomena evoked by human brain electrical stimulation. In: Devinsky, O, Beric, A, Dogali, M, editors. Electrical and magnetic stimulation of the brain and spinal cord. New York: Raven Press; 1993. p. 123–40.Google Scholar
29.Ferguson, SM, Rayport, M, Gardner, R, Kass, W, Weiner, H, Reiser, M.Similarities in mental content of psychotic states, spontaneous seizures, dreams, and responses to electrical brain stimulation in patients with temporal lobe epilepsy. Psychosom Med. 1969;31 (6):479–98.Google Scholar
30.Gloor, P.Experiential phenomena of temporal lobe epilepsy. Facts and hypotheses. Brain. 1990;113(6):1673–94.Google Scholar
31.Holmes, MD, Dodrill, CB, Ojemann, GA, Wilensky, AJ, Ojemann, LM.Outcome following surgery in patients with bitemporal interictal epileptiform patterns. Neurology. 1997;48(4):1037–40.Google Scholar
32.Jenssen, S, Liporace, J, Nei, M, O’Connor, MJ, Sperling, MR.Value of non-invasive testing when there are independent bitemporal seizures in the scalp EEG. Epilepsy Res. 2006;68(2):115–22.Google Scholar
33.Bravo, M, Quesney, LF, Ure, JA, Olivier, A, Dubeau, F, Bernasconi, A, et al.Running-up phenomenon in temporal lobe epilepsy. Abstracts of the 24th International Epilepsy Congress; 2001; Buenos Aires, Argentina. Epilepsia. 2001;42 Suppl. 2:98.Google Scholar
34.Chkhenkeli, SA, Towle, VL, Lortkipanidze, GS, Spire, JP, Bregvadze, ESh, Hunter, JD, et al.Mutually suppressive interrelations of symmetric epileptic foci in bitemporal epilepsy and their inhibitory stimulation. Clin Neurol Neurosurg. 2007;109(1): 7–22.Google Scholar
35.Inoue, Y, Mihara, T, Tottori, T, Seino, M.Electrical stimulation of the contralateral mesial temporal structure induces an ipsilateral seizure pattern in mesial temporal lobe epilepsy. Epilepsia. 1999;40(11):1602–9.CrossRefGoogle ScholarPubMed
36.Salanova, V, Markand, O, Worth, R.Temporal lobe epilepsy: analysis of failures and the role of reoperation. Acta Neurol Scand. 2005;111(2):126–33.Google Scholar
37.Bertram, EH.Temporal lobe epilepsy: Where do the seizures really begin? Epilepsy Behav. 2009; 14: 32–7.CrossRefGoogle ScholarPubMed
38.Sun, F, Morrell, M, Wharen, R Jr. Responsive cortical stimulation for the treatment of epilepsy. Neurotherapeutics. 2008;5(1): 68–74.CrossRefGoogle ScholarPubMed