Subacute neocortical stimulation (SNCS) and its effects on epileptic activity in adults and children diagnosed with focal cortical dysplasia (FCD)

Sascha Freigang*, Diego Jiménez-Jiménez, Farhana Kazi, Judit Díaz-Díaz, Marisa Pina, Maria Cunha, Gonzalo Alarcón, Richard P. Selway, Antonio Valentín

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Chronic intracranial electrical stimulation is now widely used as treatment for drug resistant epilepsy. Subacute neocortical stimulation (SNCS) can also be performed during EEG recordings with intracranial electrodes (iEEG), but its diagnostic value remains largely unknown. Methods: We assessed the effects of SNCS on the frequency of seizures and epileptiform discharges (EDs) during 290 h of iEEG- from 12 patients (6 adults, 6 children) with epilepsy secondary to focal cortical dysplasia (FCD). Results: In 9/12 patients, SNCS periods showed decreased seizure-frequency (Median -73 %, p = 0.0093). At baseline, incidence of EDs were correlated with seizure-frequency (Spearman r = 0.59). However, this correlation disappeared during SNCS and a significant change in the incidence of EDs was observed. In addition, there was a trend towards greater reduction in seizure-frequency during SNCS in patients who underwent surgery. Conclusion: In summary, SNCS can reduce seizure-frequency and changes ED-frequency. The variability in ED changes may be explained by different effects of SNCS depending on electrode location. The magnitude of seizure reduction during SNCS suggests that this technique could contribute to preoperative assessment in epilepsy surgery.

Original languageEnglish
Article number106392
JournalEpilepsy Research
Volume166
DOIs
Publication statusPublished - Oct 2020

Keywords

  • Cortical stimulation
  • Epilepsy surgery
  • Epileptiform discharges
  • intracranial EEG
  • Neuromodulation

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