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Transient hypoxemia induced by cortical electrical stimulation: A mapping study in 75 patients
Marine Loizon1, Philippe Ryvlin1, Benoit Chatard1
1From the Departments of Functional Neurology and Epileptology (M.L., J.J., S.R.) and Functional Neurosurgery (M.G.), Hospices Civils de Lyon and University of Lyon, France; Department of Clinical Neurosciences (P.R.), Centre Hospitalo-Universitaire Vaudois, Lausanne, Switzerland; INSERM U1028/CNRS UMR 5292 (B.C., J.J., R.B., M.G., L.M., L.B., S.R.), Lyon's Neuroscience Research Center; Neurology Department (L.M.), University Hospital, Saint-Etienne; and Epilepsy Institute (L.B., S.R.), Lyon, France.
Direct electrical stimulation (DES) can rarely cause breathing alterations affecting pulse oximetry (SpO2). The perisylvian cortex is most commonly associated with these significant SpO2 changes during epilepsy monitoring.
Area of Science:
- Neuroscience
- Epileptology
- Respiratory Physiology
Background:
- Direct electrical stimulation (DES) is used in epilepsy monitoring to map brain function.
- Understanding stimulation-induced physiological changes is crucial for patient safety.
- Alterations in breathing and oxygen saturation (SpO2) are potential risks.
Purpose of the Study:
- To identify specific cortical regions where DES can significantly alter breathing, impacting SpO2.
- To determine the incidence and localization of DES-induced transient hypoxemia.
Main Methods:
- Analyzed SpO2 changes following 1,352 DES in 75 epilepsy patients undergoing stereo-EEG.
- Defined transient hypoxemia as a SpO2 decrease ≥5% or nadir <90%.
- Localized stimulated contacts using MarsAtlas and Freesurfer brain atlases.
Main Results:
- Transient hypoxemia occurred in 1.2% of DES (16/1352) across 13% of patients (10/75).
- Of these events, 44% (7/16) were localized to the perisylvian cortex.
- DES-induced SpO2 decrease was significantly associated with stimulation site (p=0.019).
Conclusions:
- Significant SpO2 decrease due to DES is rare but can occur outside temporo-limbic areas.
- The perisylvian cortex is the most frequent site for DES-induced transient hypoxemia.
- This highlights the importance of considering stimulation location for potential respiratory effects.
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