Electric cortical stimulation suppresses epileptic and background activities in neocortical epilepsy and mesial temporal lobe epilepsy
Electric cortical stimulation suppresses epileptic and background activities in neocortical epilepsy and mesial temporal lobe epilepsy
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DOI：
10.1016/j.clinph.2005.02.010
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发表时间：
2005-06-01
影响因子：
4.7
通讯作者：
Shibasaki, H
中科院分区：
文献类型：
--
作者：
Kinoshita, M;Ikeda, A;Shibasaki, H
目的：评价皮质电刺激对新皮质癫痫和内侧颞叶癫痫（MTLE）患者癫痫发作区和硬膜下电极覆盖的非癫痫皮质的抑制作用。方法：4例药物难治性局灶性癫痫患者植入硬膜下电极进行术前评估。皮层功能标测通过间歇重复电刺激脉冲串进行，该脉冲串由持续时间为0.3ms的50 Hz交替方波脉冲组成，1-15 mA，在5s内。通过比较刺激前后的棘波频率和皮层电图（ECoG）功率谱，评价该刺激对癫痫发作区和非癫痫区的影响。以0.9Hz刺激癫痫发作起始区15 min进行类似的比较。结果：高频刺激癫痫发作起始区时，棘波频率降低24.7%。高频刺激发作区，在10-32 Hz频段内记录到的对数ECoG功率谱明显降低;高频刺激非癫痫区，在14-32 Hz频段内记录到的对数ECoG功率谱明显降低。在12-14 Hz频率范围内，低频电刺激癫痫发作区可使癫痫发作峰电位降低18.5%，功率略有下降。结论：高频和低频电刺激癫痫发作区对致痫性均有抑制作用。皮层电刺激后ECoG快速活动的减少表明人类皮层抑制机制的增强。(c)2005年国际临床神经生理学联合会。由Elsevier爱尔兰有限公司出版。保留所有权利。
Objective: To evaluate the suppressive effect of electric cortical stimulation upon the seizure onset zone and the non-epileptic cortex covered by subdural electrodes in patients with neocortical epilepsy and mesial temporal lobe epilepsy (MTLE).Methods: Four patients with medically intractable focal epilepsy had implanted subdural electrodes for preoperative evaluation. Cortical functional mapping was performed by intermittently repeating bursts of electric stimulation, which consisted of 50 Hz alternating square pulse of 0.3 ms duration, 1-15 mA, within 5 s. The effect of this stimulation on the seizure onset zones and on the non-epileptic areas was evaluated by comparing spike frequency and electrocorticogram (ECoG) power spectra before and after stimulation. A similar comparison was performed in stimulation of 0.9 Hz of the seizure onset zones for 15 min.Results: When the seizure onset zone was stimulated with high frequency, spike frequency decreased by 24.7%. Logarithmic ECoG power spectra recorded at stimulated electrode significantly decreased in 10-32 Hz band by high frequency stimulation of the seizure onset zone, and in 14-32 Hz band by high frequency stimulation of the non-epileptic area. Low frequency stimulation of the seizure onset zone produced 18.5% spike reduction and slight power decrease in 12-14 Hz.Conclusions: Both high and low frequency electric cortical stimulation of the seizure onset zone have a suppressive effect on epileptogenicity. Reduction of ECoG fast activities after electric cortical stimulation suggests the augmentation of inhibitory mechanisms in human cortex. (c) 2005 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.