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Electrical Cortical Stimulations Modulate Spike and Post-Spike Slow-Related High-Frequency Activities in Human Epileptic Foci
Clinical Neurophysiology ( IF 3.7 ) Pub Date : 2020-08-01 , DOI: 10.1016/j.clinph.2020.03.042
Mitsuyoshi Nakatani 1 , Riki Matsumoto 2 , Katsuya Kobayashi 3 , Takefumi Hitomi 4 , Morito Inouchi 5 , Masao Matsuhashi 5 , Masako Kinoshita 6 , Takayuki Kikuchi 7 , Kazumichi Yoshida 7 , Takeharu Kunieda 8 , Susumu Miyamoto 7 , Ryosuke Takahashi 3 , Nobutaka Hattori 9 , Akio Ikeda 5
Affiliation  

OBJECTIVE Using interictal epileptiform discharges (IEDs), consisting of spikes and post-spike slow waves (PSSs), and IED-related high-frequency activities (HFAs), we elucidated inhibitory effects of electrical cortical stimulation (ECS) on human epileptic foci. METHODS We recruited 8 patients with intractable focal epilepsy, and 50-Hz ECS was applied to the seizure-onset zone (SOZ) and non-SOZ. Before (5-min) and after (20-min) ECS, we evaluated the number of IED, the amplitudes of spikes and PSSs, spike-related HFA power, and PSS-related low gamma (30-50 Hz) activities. RESULTS SOZ stimulation significantly decreased the number of IEDs and amplitude of spikes. Spike-related HFA power values in fast ripple (200-300 Hz) and ripple (80-150 Hz) bands were significantly suppressed only by SOZ stimulation in 4 and 3 patients, respectively. Among 4 patients with discrete PSSs, the amplitude ratio of spike/PSS decreased and the PSS-related low gamma activity power increased significantly in 2 patients and marginally in 1 patient. CONCLUSIONS ECS potentially modulates cortical excitability by reducing excitation and increasing inhibition, and monitoring IED-related HFAs may help achieve the optimal effects of ECS. SIGNIFICANCE IED and IED-related HFAs are dynamic, potential surrogate markers for epileptic excitability during the interictal period.

中文翻译:

皮层电刺激调节人类癫痫病灶的尖峰和尖峰后慢相关高频活动

目的 使用由尖峰和尖峰后慢波 (PSS) 组成的发作间期癫痫样放电 (IED) 和 IED 相关的高频活动 (HFA),我们阐明了皮层电刺激 (ECS) 对人类癫痫病灶的抑制作用。方法 我们招募了 8 名顽固性局灶性癫痫患者,对癫痫发作区 (SOZ) 和非 SOZ 应用 50-Hz ECS。在 ECS 之前(5 分钟)和之后(20 分钟),我们评估了 IED 的数量、尖峰和 PSS 的幅度、尖峰相关的 HFA 功率和 PSS 相关的低伽马 (30-50 Hz) 活动。结果 SOZ 刺激显着降低了 IED 的数量和尖峰的幅度。快速纹波(200-300 Hz)和纹波(80-150 Hz)波段中与尖峰相关的 HFA 功率值分别在 4 名和 3 名患者中被 SOZ 刺激显着抑制。在 4 名具有离散 PSS 的患者中,2 名患者和 1 名患者的尖峰/PSS 振幅比降低,PSS 相关低伽马活动功率显着增加。结论 ECS 可能通过减少兴奋和增加抑制来调节皮质兴奋性,监测 IED 相关的 HFA 可能有助于实现 ECS 的最佳效果。意义 IED 和 IED 相关 HFA 是发作间期癫痫兴奋性的动态、潜在替代标志物。监测 IED 相关的 HFA 可能有助于实现 ECS 的最佳效果。意义 IED 和 IED 相关 HFA 是发作间期癫痫兴奋性的动态、潜在替代标志物。监测 IED 相关的 HFA 可能有助于实现 ECS 的最佳效果。意义 IED 和 IED 相关 HFA 是发作间期癫痫兴奋性的动态、潜在替代标志物。
更新日期:2020-08-01
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