Low Frequency Microstimulation Is Locally Excitatory in Patients With Epilepsy
Deep brain stimulation (DBS) could become a palliative treatment for patients with drug-resistant epilepsy for which surgery cannot be proposed. The objective of this study was to perform microstimulation to measure the effects of DBS in epilepsy locally at the level of a few neurons, with microelec...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2018-04-01
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| Series: | Frontiers in Neural Circuits |
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| Online Access: | http://journal.frontiersin.org/article/10.3389/fncir.2018.00022/full |
| _version_ | 1828723727288762368 |
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| author | Andrea Bartoli Rémi Tyrand Rémi Tyrand Maria I. Vargas Maria I. Vargas Shahan Momjian Shahan Momjian Colette Boëx Colette Boëx |
| author_facet | Andrea Bartoli Rémi Tyrand Rémi Tyrand Maria I. Vargas Maria I. Vargas Shahan Momjian Shahan Momjian Colette Boëx Colette Boëx |
| author_sort | Andrea Bartoli |
| collection | DOAJ |
| description | Deep brain stimulation (DBS) could become a palliative treatment for patients with drug-resistant epilepsy for which surgery cannot be proposed. The objective of this study was to perform microstimulation to measure the effects of DBS in epilepsy locally at the level of a few neurons, with microelectrode recordings, for the first time in patients with epilepsy. Microelectrode recordings were performed before, during and after microstimulation in nine patients with refractory epilepsy. Neuronal spikes were successfully extracted from multi-unit recordings with clustering in six out of seven patients during hippocampal and in one out of two patients during cortical dysplasia microstimulation (1 Hz, charge-balanced biphasic waveform, 60 μs/ph, 25 μA). The firing rates increased in four out of the six periods of microstimulation that could be analyzed. The firing rates were found higher than before microstimulation in all eight periods with increases reaching significance in six out of eight periods. Low-frequency microstimulation was hence sufficient to induce neuronal excitation lasting beyond the stimulation period. No inhibition was observed. This report presents the first evidence that microstimulation performed in epileptic patients produced locally neuronal excitation. Hence neuronal excitation is shown here as the local mechanism of action of DBS. This local excitation is in agreement with epileptogenic effects of low-frequency hippocampal macrostimulation. |
| first_indexed | 2024-04-12T12:54:43Z |
| format | Article |
| id | doaj.art-55b4aacfc48d49a58ed00748040a4f19 |
| institution | Directory Open Access Journal |
| issn | 1662-5110 |
| language | English |
| last_indexed | 2024-04-12T12:54:43Z |
| publishDate | 2018-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neural Circuits |
| spelling | doaj.art-55b4aacfc48d49a58ed00748040a4f192022-12-22T03:32:21ZengFrontiers Media S.A.Frontiers in Neural Circuits1662-51102018-04-011210.3389/fncir.2018.00022246410Low Frequency Microstimulation Is Locally Excitatory in Patients With EpilepsyAndrea Bartoli0Rémi Tyrand1Rémi Tyrand2Maria I. Vargas3Maria I. Vargas4Shahan Momjian5Shahan Momjian6Colette Boëx7Colette Boëx8Department of Neurosurgery, Faculty of Medicine, Geneva University Hospitals, Geneva, SwitzerlandDepartment of Neurology, Faculty of Medicine, Geneva University Hospitals, Geneva, SwitzerlandFaculty of Medicine, University of Geneva, Geneva, SwitzerlandFaculty of Medicine, University of Geneva, Geneva, SwitzerlandDepartment of Neuroradiology, Faculty of Medicine, Geneva University Hospitals, Geneva, SwitzerlandDepartment of Neurosurgery, Faculty of Medicine, Geneva University Hospitals, Geneva, SwitzerlandFaculty of Medicine, University of Geneva, Geneva, SwitzerlandDepartment of Neurology, Faculty of Medicine, Geneva University Hospitals, Geneva, SwitzerlandFaculty of Medicine, University of Geneva, Geneva, SwitzerlandDeep brain stimulation (DBS) could become a palliative treatment for patients with drug-resistant epilepsy for which surgery cannot be proposed. The objective of this study was to perform microstimulation to measure the effects of DBS in epilepsy locally at the level of a few neurons, with microelectrode recordings, for the first time in patients with epilepsy. Microelectrode recordings were performed before, during and after microstimulation in nine patients with refractory epilepsy. Neuronal spikes were successfully extracted from multi-unit recordings with clustering in six out of seven patients during hippocampal and in one out of two patients during cortical dysplasia microstimulation (1 Hz, charge-balanced biphasic waveform, 60 μs/ph, 25 μA). The firing rates increased in four out of the six periods of microstimulation that could be analyzed. The firing rates were found higher than before microstimulation in all eight periods with increases reaching significance in six out of eight periods. Low-frequency microstimulation was hence sufficient to induce neuronal excitation lasting beyond the stimulation period. No inhibition was observed. This report presents the first evidence that microstimulation performed in epileptic patients produced locally neuronal excitation. Hence neuronal excitation is shown here as the local mechanism of action of DBS. This local excitation is in agreement with epileptogenic effects of low-frequency hippocampal macrostimulation.http://journal.frontiersin.org/article/10.3389/fncir.2018.00022/fullDBSepilepsymicroelectrodemicrostimulationsafetyhippocampus |
| spellingShingle | Andrea Bartoli Rémi Tyrand Rémi Tyrand Maria I. Vargas Maria I. Vargas Shahan Momjian Shahan Momjian Colette Boëx Colette Boëx Low Frequency Microstimulation Is Locally Excitatory in Patients With Epilepsy Frontiers in Neural Circuits DBS epilepsy microelectrode microstimulation safety hippocampus |
| title | Low Frequency Microstimulation Is Locally Excitatory in Patients With Epilepsy |
| title_full | Low Frequency Microstimulation Is Locally Excitatory in Patients With Epilepsy |
| title_fullStr | Low Frequency Microstimulation Is Locally Excitatory in Patients With Epilepsy |
| title_full_unstemmed | Low Frequency Microstimulation Is Locally Excitatory in Patients With Epilepsy |
| title_short | Low Frequency Microstimulation Is Locally Excitatory in Patients With Epilepsy |
| title_sort | low frequency microstimulation is locally excitatory in patients with epilepsy |
| topic | DBS epilepsy microelectrode microstimulation safety hippocampus |
| url | http://journal.frontiersin.org/article/10.3389/fncir.2018.00022/full |
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