Electrode location and clinical outcome in hippocampal electrical stimulation for mesial temporal lobe epilepsy

Autor: Giovanni Foletti, Claudio Pollo, Margitta Seeck, Serge Vulliemoz, Percy Bondallaz, Colette Boex, Laurent Spinelli, Andrea O. Rossetti
Rok vydání: 2013
Předmět:
Male
Deep Brain Stimulation
Electroencephalography/methods
medicine.medical_treatment
Hippocampus
Hippocampal formation
Functional Laterality
Functional Laterality/physiology
Epilepsy
0302 clinical medicine
Temporal lobe epilepsy
Pharmacoresistance
Outcome
Brain Mapping
0303 health sciences
Subiculum
Electroencephalography
General Medicine
Middle Aged
Temporal Lobe
Neuromodulation (medicine)
Electrodes
Implanted
Treatment Outcome
Neurology
Anesthesia
Cardiology
Female
Adult
medicine.medical_specialty
Deep brain stimulation
Clinical Neurology
Epilepsy
Temporal Lobe/therapy
03 medical and health sciences
Deep Brain Stimulation/methods
Internal medicine
Brain Mapping/methods
Hippocampus/pathology
medicine
Humans
Ictal
030304 developmental biology
Hippocampal sclerosis
business.industry
Temporal Lobe/pathology
medicine.disease
ddc:616.8
nervous system diseases
Epilepsy
Temporal Lobe
nervous system
Neurology (clinical)
business
030217 neurology & neurosurgery
Zdroj: Seizure, Vol. 22, No 5 (2013) pp. 390-395
ISSN: 1059-1311
DOI: 10.1016/j.seizure.2013.02.007
Popis: PurposeTo study the clinical outcome in hippocampal deep brain stimulation (DBS) for the treatment of patients with refractory mesial temporal lobe epilepsy (MTLE) according to the electrode location.MethodsEight MTLE patients implanted in the hippocampus and stimulated with high-frequency DBS were included in this study. Five underwent invasive recordings with depth electrodes to localize ictal onset zone prior to chronic DBS. Position of the active contacts of the electrode was calculated on postoperative imaging. The distances to the ictal onset zone were measured as well as atlas-based hippocampus structures impacted by stimulation were identified. Both were correlated with seizure frequency reduction.ResultsThe distances between active electrode location and estimated ictal onset zone were 11±4.3 or 9.1±2.3mm for patients with a >50% or 50% seizure frequency reduction, 100% had the active contacts located 3mm to the subiculum.ConclusionDecrease of epileptogenic activity induced by hippocampal DBS in refractory MTLE: (1) seems not directly associated with the vicinity of active electrode to the ictal focus determined by invasive recordings; (2) might be obtained through the neuromodulation of the subiculum.
Databáze: OpenAIRE
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