Functional response of electrical stimulation of the amygdala in drug-refractory epilepsy patients and its role in the localization of epileptogenic zone
Objective To explore the physiological function of the amygdala and its role in the localization of epileptogenic zone(EZ)by analyzing the symptoms produced by electrical stimulation of the amygdala in drug-refractory epilepsy patients.Methods A retrospective analysis was conducted on the electrical stimulation data of 49 drug-refractory epilepsy patients who underwent stereoelectroencephalography(SEEG)electrode implantation at the Department of Functional Neurosurgery,Xuanwu Hospital,Capital Medical University from January 2017 to April 2023.According to the subject report and clinical observation of the clinical symptoms produced by the electrical stimulation of the amygdala,statistical analysis was conducted on the EZ of epilepsy patients in whom electrical stimulation induced the aura of seizures.Results Among 49 patients,a total of 55 SEEG electrodes were implanted in the amygdala,with 192 contacts located in the amygdala.After electrostatic stimuli,44 patients developed a total of 174 clinical symptoms,including 40(23.0％)cases of emotional reactions,52(29.9％)cases of vegetative symptoms,33(19.0％)cases of somatic sensations,32(18.4％)cases of head sensations,10(5.7％)cases of visual symptoms,3(1.7％)cases of olfactory symptoms and 4(2.3％)cases of motion symptoms.Of the 174 clinical symptoms of 44 patients,the clinical symptoms of 82(47.1％)procedures of stimulations in 22(50.0％)patients were auras.The EZ was located in the amygdala and hippocampus in 39 procedures(47.6％,9 patients),the amygdala in 9 procedures(11.0％,1 patient),the hippocampus in 17 procedures(20.7％,7 patients),the frontal lobe in 13 procedures(15.9％,3 patients)and the insula lobe in 4 procedures(4.9％,2 patients).Conclusions Electrical stimulation of the amygdala in drug-refractory epilepsy patients can induce a variety of functional reactions.Some may be the reaction of the amygdala itself,and some may be the aura of epileptic seizures.It suggests that the amygdala participates in a number of physiological functions of the body and play a role in key nodes of the seizure network.
Drug resistant,epilepsyAmygdalaElectric stimulationNeurologic manifestations
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