Electrode location and clinical outcome in hippocampal electrical stimulation for mesial temporal lobe epilepsy

Abstract Purpose To study the clinical outcome in hippocampal deep brain stimulation (DBS) for the treatment of patients with refractory mesial temporal lobe epilepsy (MTLE) according to the electrode location. Methods Eight MTLE patients implanted in the hippocampus and stimulated with high-frequen...

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Bibliographic Details
Published in:Seizure (London, England) England), 2013-06, Vol.22 (5), p.390-395
Main Authors: Bondallaz, Percy, Boëx, Colette, Rossetti, Andrea O, Foletti, Giovanni, Spinelli, Laurent, Vulliemoz, Serge, Seeck, Margitta, Pollo, Claudio
Format: Article
Language:English
Subjects:
Adult
Brain Mapping - methods
Deep brain stimulation
Deep Brain Stimulation - methods
Electrodes, Implanted
Electroencephalography - methods
Epilepsy, Temporal Lobe - therapy
Female
Functional Laterality - physiology
Hippocampal sclerosis
Hippocampus - pathology
Humans
Male
Middle Aged
Neurology
Outcome
Pharmacoresistance
Temporal Lobe - pathology
Temporal lobe epilepsy
Treatment Outcome
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Summary:Abstract Purpose To study the clinical outcome in hippocampal deep brain stimulation (DBS) for the treatment of patients with refractory mesial temporal lobe epilepsy (MTLE) according to the electrode location. Methods Eight MTLE patients implanted in the hippocampus and stimulated with high-frequency DBS were included in this study. Five underwent invasive recordings with depth electrodes to localize ictal onset zone prior to chronic DBS. Position of the active contacts of the electrode was calculated on postoperative imaging. The distances to the ictal onset zone were measured as well as atlas-based hippocampus structures impacted by stimulation were identified. Both were correlated with seizure frequency reduction. Results The distances between active electrode location and estimated ictal onset zone were 11 ± 4.3 or 9.1 ± 2.3 mm for patients with a >50% or 50% seizure frequency reduction, 100% had the active contacts located 3 mm to the subiculum. Conclusion Decrease of epileptogenic activity induced by hippocampal DBS in refractory MTLE: (1) seems not directly associated with the vicinity of active electrode to the ictal focus determined by invasive recordings; (2) might be obtained through the neuromodulation of the subiculum.
ISSN:1059-1311
1532-2688
DOI:10.1016/j.seizure.2013.02.007