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

Bondallaz, Percy; Boëx, Colette; Rossetti, Andrea O.; Foletti, Giovanni; Spinelli, Laurent; Vulliemoz, Serge; Seeck, Margitta; Pollo, Claudio (2013). Electrode location and clinical outcome in hippocampal electrical stimulation for mesial temporal lobe epilepsy. Seizure - European journal of epilepsy, 22(5), pp. 390-395. Elsevier 10.1016/j.seizure.2013.02.007

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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±2.3mm for patients with a >50% or <50% reduction in seizure frequency. In patients (N=6) showing a >50% seizure frequency reduction, 100% had the active contacts located <3mm from the subiculum (p<0.05). The 2 non-responders patients were stimulated on contacts located >3mm 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.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurosurgery
UniBE Contributor:	Pollo, Claudio
Subjects:	600 Technology > 610 Medicine & health
ISSN:	1059-1311
Publisher:	Elsevier
Language:	English
Submitter:	Nicole Söll
Date Deposited:	03 Apr 2014 09:02
Last Modified:	05 Dec 2022 14:29
Publisher DOI:	10.1016/j.seizure.2013.02.007
PubMed ID:	23540624
URI:	https://boris.unibe.ch/id/eprint/44514