Human entorhinal cortex electrical stimulation evoked short-latency potentials in the broad neocortical regions: Evidence from cortico-cortical evoked potential recordings
Human entorhinal cortex electrical stimulation evoked short-latency potentials in the broad neocortical regions: Evidence from cortico-cortical evoked potential recordings
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DOI：
10.1002/brb3.1366
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发表时间：
2019-07-30
影响因子：
3.1
通讯作者：
Ikeda, Akio
中科院分区：
文献类型：
--
作者：
Takeyama, Hirofumi;Matsumoto, Riki;Ikeda, Akio
目的应用皮层-皮层诱发电位（CCEP）研究电刺激人内嗅皮层（EC）诱发反应的临床意义。方法我们纳入了9例难治性内侧颞叶癫痫患者，他们接受了硬膜下或深部电极的侵入性术前评估。单脉冲电刺激EC和梭状回（FG），并比较它们的诱发电位。分析诱发电位与韦氏记忆量表（WMS-R）评分的相关性，以探讨记忆回路是否参与诱发电位的产生。结果在大多数放置于新皮层的电极上，EC刺激可诱发出独特的正极性诱发电位，称为“广泛性P1”（P1 w）。与FG刺激相比，EC刺激诱发的P1 w具有出现率高、峰潜伏期短（平均20.1ms）、峰幅度小、不同记录部位波形一致等特点。电刺激EC后部诱发的P1 w潜伏期短、波幅大。P1 w峰值振幅与WMS-R视觉记忆评分呈正相关（r = 0.69）。1例患者在海马内植入深部电极，在海马前部电极和刺激点附近的EC记录到巨大诱发电位。结论电刺激人EC可诱发广泛的皮层短潜伏期电位。P1 w的起源尚不清楚，尽管有限的证据表明P1 w是由EC本身和海马的巨大诱发电位的体积传导产生的远场电位。本研究的意义在于，这些诱发电位可能是各种神经系统疾病中记忆障碍的潜在生物标志物，并且我们为人类EC沿前后轴的功能细分提供了直接证据。
Objective We aimed at clarifying the clinical significance of the responses evoked by human entorhinal cortex (EC) electrical stimulation by means of cortico-cortical evoked potentials (CCEPs). Methods We enrolled nine patients with medically intractable medial temporal lobe epilepsy who underwent invasive presurgical evaluations with subdural or depth electrodes. Single-pulse electrical stimulation was delivered to the EC and fusiform gyrus (FG), and their evoked potentials were compared. The correlation between the evoked potentials and Wechsler Memory Scale-Revised (WMS-R) score was analyzed to investigate whether memory circuit was involved in the generation of the evoked potentials. Results In most electrodes placed on the neocortex, EC stimulation induced unique evoked potentials with positive polarity, termed as "widespread P1" (P1w). Compared with FG stimulation, P1w induced by EC stimulation were distinguished by their high occurrence rate, short peak latency (mean: 20.1 ms), small peak amplitude, and waveform uniformity among different recording sites. A stimulation of more posterior parts of the EC induced P1w with shorter latency and larger amplitude. P1w peak amplitude had a positive correlation (r = .69) with the visual memory score of the WMS-R. In one patient, with depth electrode implanted into the hippocampus, the giant evoked potentials were recorded in the electrodes of the anterior hippocampus and EC near the stimulus site. Conclusions The human EC electrical stimulation evoked the short-latency potentials in the broad neocortical regions. The origin of P1w remains unclear, although the limited evidence suggests that P1w is the far-field potential by the volume conduction of giant evoked potential from the EC itself and hippocampus. The significance of the present study is that those evoked potentials may be a potential biomarker of memory impairment in various neurological diseases, and we provided direct evidence for the functional subdivisions along the anterior-posterior axis in the human EC.