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Clin Neurophysiol ; 127(2): 1088-1098, 2016 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-26377063

RESUMEN

OBJECTIVE: Single Pulse Electrical Stimulation (SPES) probes epileptogenic cortex during electrocorticography. Two SPES responses are described: pathological delayed responses (DR, >100 ms) associated with the seizure onset zone (SOZ) and physiological early responses (ER, <100 ms) that map cortical connectivity. We analyzed properties of ERs, including frequencies >80 Hz, in the SOZ and seizure propagation areas. METHODS: We used data from 12 refractory epilepsy patients. SPES consisted of 10 pulses of 1 ms, 4-8 mA and 5s interval on adjacent electrodes pairs. Data were available at 2048 samples/s for six and 512 samples/s (22 bits) for eight patients and analyzed in the time-frequency (TF) and time-domain (TD). RESULTS: Electrodes with ERs were stronger associated with SOZ than non-SOZ electrodes. ERs with frequency content >80 Hz exist and are specific for SOZ channels. ERs evoked by stimulation of seizure onset electrodes were associated with electrodes involved in seizure propagation. CONCLUSION: Analysis of ERs can reveal aspects of pathology, manifested by association with seizure propagation and areas with high ER numbers that coincide with the SOZ. SIGNIFICANCE: Not only DRs, but also ERs could have clinical value for mapping epileptogenic cortex and help to unravel aspects of the epileptic network.


Asunto(s)
Corteza Cerebral/fisiopatología , Electrocorticografía/métodos , Epilepsia/diagnóstico , Epilepsia/fisiopatología , Adolescente , Adulto , Mapeo Encefálico/métodos , Niño , Estimulación Eléctrica/métodos , Electrodos Implantados , Electroencefalografía/métodos , Femenino , Humanos , Masculino , Adulto Joven
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