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Electrical Stimulation Sensorimotor Mapping with Stereo-EEG
Clinical Neurophysiology ( IF 3.7 ) Pub Date : 2020-08-01 , DOI: 10.1016/j.clinph.2020.04.159
Ravindra Arya 1 , Brian Ervin 2 , Timothy Holloway 3 , Jonathan Dudley 4 , Paul S Horn 1 , Jason Buroker 5 , Leonid Rozhkov 3 , Craig Scholle 3 , Anna W Byars 1 , James L Leach 6 , Francesco T Mangano 7 , Hansel M Greiner 1 , Katherine D Holland 1
Affiliation  

OBJECTIVE We evaluated stereo-EEG electrical stimulation mapping (ESM) for localization of anatomic sensorimotor parcels in pediatric patients with drug-resistant epilepsy. We also analyzed sensorimotor and after-discharge thresholds, and the somatotopy of sensorimotor responses. METHODS ESM was performed with 50 Hz, biphasic, 2-3 s trains, using 1-9 mA current. Pre- and post-implant neuroimaging was co-registered and intersected with Neurosynth reference, to classify each electrode contact as lying within/outside an anatomic sensorimotor parcel. Indices of diagnostic performance were computed. Sensorimotor and after-discharge thresholds were analyzed using multivariable linear mixed models. RESULTS In 15 patients (6 females), aged 5.5-21.2 years, ESM showed high accuracy (0.80), high specificity (0.86), and diagnostic odds ratio (11.4, p < 0.0001) for localization of sensorimotor parcels. Mean sensorimotor threshold (3.4 mA) was below mean after-discharge threshold (4.2 mA, p = 0.0004). Sensorimotor and after-discharge thresholds showed a significant decrease with increasing intelligence quotient. Somatotopy of sensorimotor responses was mapped to standardized brain parcels. CONCLUSIONS We provide evidence for diagnostic validity and safety of stereo-EEG sensorimotor ESM. SIGNIFICANCE The somatotopy of sensorimotor responses elicited with electrical stimulation provide new insights into mechanisms of motor control and sensory perception.

中文翻译:

立体脑电图的电刺激感觉运动映射

目标我们评估立体脑电图电刺激映射 (ESM) 用于定位儿童耐药性癫痫患者的解剖感觉运动包。我们还分析了感觉运动和放电后阈值,以及感觉运动反应的躯体分布。方法 ESM 使用 50 Hz、双相、2-3 s 序列,使用 1-9 mA 电流进行。植入前和植入后的神经影像被共同注册并与 Neurosynth 参考相交,以将每个电极接触分类为位于解剖感觉运动包裹内/外。计算了诊断性能的指标。使用多变量线性混合模型分析感觉运动和后放电阈值。结果 在 15 名患者(6 名女性)中,年龄 5.5-21.2 岁,ESM 显示出高准确度 (0.80)、高特异性 (0.86) 和诊断优势比 (11.4,p < 0. 0001) 用于感觉运动包裹的定位。平均感觉运动阈值 (3.4 mA) 低于平均放电后阈值 (4.2 mA,p = 0.0004)。感觉运动和放电后阈值随着智商的增加而显着降低。感觉运动反应的体表被映射到标准化的脑包裹。结论 我们为立体脑电感觉运动 ESM 的诊断有效性和安全性提供了证据。意义 电刺激引起的感觉运动反应的体位学为运动控制和感觉知觉的机制提供了新的见解。感觉运动和放电后阈值随着智商的增加而显着降低。感觉运动反应的体表被映射到标准化的脑包裹。结论 我们为立体脑电感觉运动 ESM 的诊断有效性和安全性提供了证据。意义 电刺激引起的感觉运动反应的体位学为运动控制和感觉知觉的机制提供了新的见解。感觉运动和放电后阈值随着智商的增加而显着降低。感觉运动反应的体表被映射到标准化的脑包裹。结论 我们为立体脑电感觉运动 ESM 的诊断有效性和安全性提供了证据。意义 电刺激引起的感觉运动反应的体位学为运动控制和感觉知觉的机制提供了新的见解。
更新日期:2020-08-01
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