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A Multimodal Imaging- and Stimulation-based Method of Evaluating Connectivity-related Brain Excitability in Patients with Epilepsy
Published on: November 13, 2016
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Imaging the effective networks associated with cortical function through intracranial high-frequency stimulation
Andrei Barborica1,2, Irina Oane3, Cristian Donos1
1Physics Department, University of Bucharest, Bucharest, Romania.
Human Brain Mapping
|December 14, 2021
Summary
Direct electrical stimulation (DES) mapping reveals remote brain network activations crucial for clinical effects in epilepsy surgery. This new method improves understanding of brain networks and seizure spread, guiding surgical interventions and improving patient outcomes.
Area of Science:
- Neuroscience
- Neurosurgery
- Epileptology
Background:
- Direct electrical stimulation (DES) is the gold standard for mapping cortical function.
- Accurate mapping of eloquent cortex is vital for successful epilepsy surgery with minimal deficit.
- Both local and remote brain activations contribute to clinical effects during stimulation.
Purpose of the Study:
- To introduce a novel intracranial stimulation paradigm and signal analysis method.
- To disambiguate electroencephalography (EEG) responses from stimulation artifacts.
- To highlight the spatial extent of brain networks associated with clinical effects.
Main Methods:
- Utilized stereoelectroencephalography (SEEG) in 26 drug-resistant epilepsy patients.
- Modified DES protocol by alternating biphasic pulse polarity to separate artifact from neural response.
- Employed frequency-domain analysis of EEG signals during DES.
- Created local and distant connectivity maps using intersubject averaging and HCP-MMP parcellation.
Main Results:
- Successfully captured remote brain activations and mapped their associated networks.
- Identified 614 stimulations evoking specific clinical effects with detailed connectivity maps.
- Demonstrated the ability to distinguish neural responses from stimulation artifacts.
Conclusions:
- The novel DES approach effectively maps brain networks involved in clinical effects.
- These connectivity maps enhance understanding of brain network extent for surgical guidance.
- The method aids in understanding seizure propagation patterns based on semiology timelines.
