Electrophysiological analysis of electrical stimulation of centromedian thalamic nucleus and responses of various brain regions
Objective To investigate the occurrence and amplitude of responses of different brain regions to electrical stimulation of the centromedian thalamic nucleus(CMT)in patients with drug-resistant epilepsy who underwent implantation of stereoelectroencephalography(SEEG)electrodes.Methods The clinical data of 10 patients with drug-resistant epilepsy who underwent SEEG electrode implantation in CMT and suspicious onset zone at the same time from January 2022 to May 2023 at the Clinic Neuroscience Center of Shanghai Ruijin Hospital,Shanghai Jiao Tong University School of Medicine were retrospectively analyzed.Through electrical stimulation and recording of effective electrophysiological signals,the occurrence rate of response contacts and response amplitude in different brain regions were compared.Results A total of 1062 effective contacts were determined in 10 patients,and the same-frequency responses were recorded in 491 contacts(46.2％).The occurrence of response contacts in the anterior and posterior central gyri was the highest[81.0％(51/63)],followed by the parietal and frontal lobes[56.5％(61/108)and 53.2％(253/475),respectively].The two brain regions with the lowest rates were temporal lobe[18.6％(22/118)]and hippocampus and amygdala(4/19).The difference of response contact occurrence among various brain regions was statistically significant(H=14.13,P=0.049).The response amplitude of 10 patients was 40.3(0-1 000.0)μV.In terms of the response degree of different brain regions,the highest amplitude was observed in the hippocampus and amygdala[398.0(0-1 000.0)μV],followed by parietal lobe[81.5(12.0-336.2)μV].The lowest amplitude was found in temporal lobe[19.5(8.1-27.8)pV].After removing the outliers,there was no significant difference in the response degree of different brain regions(H=8.41,P=0.298).Conclusions When SEEG electrodes are used to electrically stimulate CMT,there are differences in the responses of different brain areas in patients with drug-resistant epilepsy.The response ratio of brain areas surrounding the central sulcus is higher than that of brain areas far away from the central sulcus.After removing the outliers,there is no obvious difference in the response levels of different brain areas.
Drug resistant epilepsyNeurophysiological monitoringCentromedian nucleusStereoelectroencephalographyResponse in brain regions
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