Comparison of Thresholds between Bipolar and Monopolar Electrical Cortical Stimulation

Electrical cortical stimulation is widely performed and is the gold standard for functional mapping in intractable epilepsy patients; however, a standard protocol has not yet been established. With respect to stimulation methods, two techniques can be applied: monopolar and bipolar stimulation. We c...

Full description

Saved in:
Bibliographic Details
Published in:Neurologia Medico-Chirurgica 2022/06/15, Vol.62(6), pp.294-299
Main Authors: TAKAHASHI, Yasuhiro, ENATSU, Rei, KANNO, Aya, IMATAKA, Seiichiro, KOMURA, Shoichi, TAMADA, Tomoaki, SAKASHITA, Kyoya, CHIBA, Ryohei, SAITO, Takuro, MIKUNI, Nobuhiro
Format: Article
Language:English
Subjects:
bipolar stimulation
electrical cortical stimulation
Epilepsy
epilepsy surgery
functional brain mapping
Language
Mapping
monopolar stimulation
Original
Patients
Sensory evaluation
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Electrical cortical stimulation is widely performed and is the gold standard for functional mapping in intractable epilepsy patients; however, a standard protocol has not yet been established. With respect to stimulation methods, two techniques can be applied: monopolar and bipolar stimulation. We compared the threshold to induce clinical symptoms between these two stimulation techniques. Twenty patients with intractable epilepsy who underwent electrical cortical stimulation for functional mapping were retrospectively investigated. We evaluated the stimulation intensity thresholds required to induce motor, sensory, and language symptoms. A total of 114 electrodes in 20 patients were used to investigate motor, sensory, and language symptoms. The thresholds required to induce motor (median value, bipolar: 4 mA, monopolar: 5 mA, p < 0.05) and language symptoms (bipolar: 8 mA, monopolar: 10 mA, p < 0.0005) were significantly higher for monopolar stimulation than those for bipolar stimulation. However, for sensory symptoms, no significant differences were found in the required thresholds between monopolar and bipolar stimulation (bipolar: 4 mA, monopolar: 4 mA, p = 0.474). Bipolar cortical stimulation required lower intensities to produce clinical motor and language symptoms and thus would be safe and suitable for screening of the eloquent area in functional mapping.
ISSN:0470-8105
1349-8029
DOI:10.2176/jns-nmc.2021-0389