Acute Effects of High-Frequency Insular Stimulation on Interictal Epileptiform Discharge Rates in Patients with Refractory Epilepsy
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants and Surgical Implantation
2.2. Stimulation Parameters
2.3. Data Acquisition and Spike Detection
2.4. Statistical Analysis
3. Results
- Group 1: HF-DBS-aINS in Patients with an Anterior Insular Epileptic Focus
- Group 2: HFS-pINS in Patients with a Posterior Insular Epileptic Focus
- Group 3: HFS-pINS in Patients with an Anterior Insular Epileptic Focus
- Group 4: HFS-pINS in Patients without an Insular Epileptic Focus
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Patient | Age at Onset of Epilepsy/Age at Invasive EEG | Gender/Dominance | Side and Location of Epileptic Focus | Stimulation Intensity (mA) | Location of Stimulated Insular Contacts |
---|---|---|---|---|---|
1 | 9/25 | Fe/R | R, junction between OF and ant INS | 3.3 | R aINS |
2 | 16/47 | M/R | L, P operculum, pINS | 0.4 | L pINS |
3 | 5/38 | Fe/R | L, F operculum + mid-INS and aINS | 1.5 | L pINS |
4 | 22/32 | Fe/R | R, pINS | 7 | R INS |
5 | unknown/25 | M/R | L, FT | 7 | L pINS |
6 | 6 months/41 | M/R | R, OF | 6 | R pINS |
Patient 1 | IED rate (IED/minute); median (IQR) | ||||||
IED localizations | B | S1 | PS1 | S2 | PS2 | ||
1st 10 min | 2nd 10 min | 1st 10 min | 2nd 10 min | ||||
OF | 9 (15.75) | 0 (2.25) ↓ (p = 0.004) | 15.50 (9.75) | 20.50 (16) ↑ (p = 0.023) | 17 (19.17) | 22 (18) ↑ (p = 0.013) | 16.50 (18.50) |
aINS | 1 (3.75) | 0 (0.25) ↓ (p = 0.042) | 0 (0) ↓ (p = 0.003) | 0 (0) ↓ (p = 0.003) | 0 (0) ↓ (p = 0.003) | 0 (0) ↓ (p = 0.003) | 0 (0) ↓ (p = 0.003) |
OF-aINS | 31 (37.75) | 7 (21.75) ↓ (p = 0.025) | 35 (38.75) | 12.50 (60) | 22.5 (7.0) | 32.5 (17) | 36 (27.25) |
Patient 2 | IED rate (IED/minute); median (IQR) | ||||||
IED localizations | B | S1 | PS1 | S2 | PS2 | ||
1st 10 min | 2nd 10 min | 1st 10 min | 2nd 10 min | ||||
T-P operculo-pINS | 46 (13.75) | 24 (15.75) ↓ (p = 0.006) | 45 (20.5) | 51 (7.50) ↑ (p = 0.007) | 49 (8.25) | 37 (14) | 41.50 (6.5) |
lateral T | 0 (1) | 0 (0) | 0 (0) | 0 (0) | 0 (2) | 0 (1) | 0 (0) |
Synchronous | 2 (3.75) | 0 (1) ↓ (p = 0.03) | 0 (1) ↓ (p = 0.03) | 0 (2.25) | 0 (1) ↓ (p = 0.03) | 5 (9.25) ↑ (p = 0.038) | 2 (3.25) |
Patient 3 | IED rate (IED/minute); median (IQR) | ||||||
IED localizations | B | S1 | PS1 | S2 | PS2 | ||
1st 10 min | 2nd 10 min | 1st 10 min | 2nd 10 min | ||||
aINS | 113 (54.75) | 126 (92.25) | 106.50 (8.25) | 123.5 (67.26) | 67 (86.5) | 94 (52.5) | 81.5 (60.6) |
IFG-aINS | 32 (36.5) | 60 (40) | 20 (20.75) | 29.5 (34.75) | 29.5 (19) | 18 (14.25) ↓ (p = 0.022) | 22 (21.25) |
STG-aINS | 0 (4.25) | 0 (2) | 0 (4.25) | 0 (1.75) | 0 (1.25) | 0 (0) | 0 (2.0) |
synchronous | 1 (11.75) | 13 (41) | 0 (1) | 0 (2) | 0 (5.25) | 0.5 (3.25) | 0 (1.25) |
Patient 4 | IED rate (IED/minute); median (IQR) | ||||||
IED localizations | B | S1 | PS1 | S2 | PS2 | ||
1st 10 min | 2nd 10 min | 1st 10 min | 2nd 10 min | ||||
T-P opercula-pINS | 1.6 (2.75) | 0 (0) ↓ (p < 0.001) | 0 (0) ↓ (p < 0.001) | 2 (3.0) | 0 (0) ↓ (p < 0.001) | 0 (1.25) | 0.5 (1.0) ↓ (p = 0.040) |
Synchronous | 0 (0) | 0 (0) | 0 (0) | 0 (0.25) | 0 (0) | 0 (0) | 0 (0) |
Patient 5 | IED rate (IED/minute); median (IQR) | ||||||
IED localizations | B | S1 | PS1 | S2 | PS2 | ||
1st 10 min | 2nd 10 min | 1st 10 min | 2nd 10 min | ||||
lateral T | 2.5 (4.5) | 1.5 (7.25) | 0 (1.25) ↓ (p = 0.010) | 3 (5.5) | 2.5 (5.75) | 2 (4.25) | 4.5 (5.0) |
lateral prefrontal | 0 (1) | 0 (0.25) | 1.5 (2.25) ↑ (p = 0.005) | 0.5 (2.25) | 0 (1.0) | 0.5 (2.0) | 0.5 (2.0) |
Synchronous | 1 (6.5) | 0 (1.25) | 0 (1.25) | 3 (5.5) | 0 (0.75) ↓ (p = 0.044) | 2 (4.25) | 1 (4) |
Patient 6 | IED rate (IED/minute); median (IQR) | ||||||
IED localizations | B | S1 | PS1 | S2 | PS2 | ||
1st 10 min | 2nd 10 min | 1st 10 min | 2nd 10 min | ||||
OF | 6.50 (4.50) | 16 (7.0) ↑ (p = 0.001) | 8 (6.50) | 9 (10.75) | 21 (11.25) ↑ (p < 0.001) | 8 (8.25) | 5 (5) |
pINS | 0 (1) | 0 (0) | 0 (1) | 0 (0) | 0 (0) | 0 (0.25) | 0 (0) |
Posterior T | 1.5 (3) | 0 (3) | 3.5 (4.25) | 1.5 (3.25) | 0 (0.75) | 0.5 (3.5) | 0 (2) |
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Tran, T.P.Y.; Dionne, A.; Toffa, D.; Bergeron, D.; Obaid, S.; Robert, M.; Bouthillier, A.; Assi, E.B.; Nguyen, D.K. Acute Effects of High-Frequency Insular Stimulation on Interictal Epileptiform Discharge Rates in Patients with Refractory Epilepsy. Brain Sci. 2022, 12, 1616. https://doi.org/10.3390/brainsci12121616
Tran TPY, Dionne A, Toffa D, Bergeron D, Obaid S, Robert M, Bouthillier A, Assi EB, Nguyen DK. Acute Effects of High-Frequency Insular Stimulation on Interictal Epileptiform Discharge Rates in Patients with Refractory Epilepsy. Brain Sciences. 2022; 12(12):1616. https://doi.org/10.3390/brainsci12121616
Chicago/Turabian StyleTran, Thi Phuoc Yen, Antoine Dionne, Denahin Toffa, David Bergeron, Sami Obaid, Manon Robert, Alain Bouthillier, Elie Bou Assi, and Dang Khoa Nguyen. 2022. "Acute Effects of High-Frequency Insular Stimulation on Interictal Epileptiform Discharge Rates in Patients with Refractory Epilepsy" Brain Sciences 12, no. 12: 1616. https://doi.org/10.3390/brainsci12121616