After-discharges and seizures during pediatric extra-operative electrical cortical stimulation functional brain mapping: Incidence, thresholds, and determinants
After-discharges and seizures during pediatric extra-operative electrical cortical stimulation functional brain mapping: Incidence, thresholds, and determinants
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DOI：
10.1016/j.clinph.2017.06.259
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发表时间：
2017-10-01
影响因子：
4.7
通讯作者：
Arya, Ravindra
中科院分区：
文献类型：
--
作者：
Aungaroon, Gewalin;Vera, Alonso Zea;Arya, Ravindra
目的：本研究检查了皮层电刺激 (ECS) 诱发的放电后 (AD) 和癫痫发作的发生率、阈值和决定因素。 方法：回顾皮层电图记录以确定 ECS 诱发的 AD 和癫痫发作的发生率。对 AD/癫痫发作的预测因素及其阈值进行了多变量分析。 结果：在 122 名患者中，AD 和癫痫发作的发生率分别为 77% (94/122) 和 35% (43/122)。男性（优势比 [OR] 2.92，95% CI 1.21-7.38，p = 0.02）和 MRI 阴性患者（OR 3.69，95% CI 1.24-13.7，p = 0.03）被发现 ECS 诱发 AD 的几率较高。可以看到 AD 阈值随着年龄的增长而降低的显着趋势（回归系数 -0.151，95% Cl -0.267 至 -0.035，p = 0.011）。 ECS 诱发的癫痫发作在具有偏侧功能成像（OR 6.62，95% Cl 1.36-55.56，p = 0.036，对于正电子发射断层扫描）和存在 AD（OR 3.50，95% Cl 1.12-13.36，p = 0.043）的患者中更有可能。 & para;& para;结论：ECS 与高AD 和癫痫发作的发生率。随着年龄的增长，电流阈值降低，AD/癫痫发作的可能性增加。 & para;& para;意义：ECS 脑图绘制过程中的 AD 和癫痫发作具有潜在危险，并影响其功能有效性。因此，需要更安全的、具有改善的神经生理学有效性的大脑绘图方法。 (C) 2017 年国际临床神经生理学联合会。由爱思唯尔爱尔兰有限公司出版。保留所有权利。
Objective: This study examined the incidence, thresholds, and determinants of electrical cortical stimulation (ECS)-induced after-discharges (ADs) and seizures.& para;& para;Methods: Electrocorticograph recordings were reviewed to determine incidence of ECS-induced ADs and seizures. Multivariable analyses for predictors of AD/seizure occurrence and their thresholds were performed.& para;& para;Results: In 122 patients, the incidence of ADs and seizures was 77% (94/122) and 35% (43/122) respectively. Males (odds ratio [OR] 2.92, 95% CI 1.21-7.38, p = 0.02) and MRI-negative patients (OR 3.69, 95% CI 1.24-13.7, p = 0.03) were found to have higher odds of ECS-induced ADs. A significant trend for decreasing AD thresholds with age was seen (regression co-efficient -0.151, 95% Cl -0.267 to -0.035, p = 0.011 ). ECS-induced seizures were more likely in patients with lateralized functional imaging (OR 6.62, 95% Cl 1.36- 55.56, p = 0.036, for positron emission tomography) and presence of ADs (OR 3.50, 95% Cl 1.12-13.36, p = 0.043).& para;& para;Conclusions: ECS is associated with a high incidence of ADs and seizures. With age, current thresholds decrease and the probability for AD/seizure occurrence increases.& para;& para;Significance: ADs and seizures during ECS brain mapping are potentially hazardous and affect its functional validity. Thus, safer method(s) for brain mapping with improved neurophysiologic validity are desirable. (C) 2017 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.