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Optimizing Parameters for Terminating Cortical Afterdischarges with Pulse Stimulation
Author(s) -
Motamedi Gholam K.,
Lesser Ronald P.,
Miglioretti Diana L.,
MizunoMatsumoto Yuko,
Gordon Barry,
Webber William R. S.,
Jackson Darryl C.,
Sepkuty Jehuda P.,
Crone Nathan E.
Publication year - 2002
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1046/j.1528-1157.2002.24901.x
Subject(s) - stimulation , stimulus (psychology) , rhythm , neuroscience , pulse (music) , medicine , psychology , physics , voltage , quantum mechanics , psychotherapist
Summary: Purpose: We previously reported that brief pulses of electrical stimulation (BPSs) can terminate afterdischarges (ADs) during cortical stimulation. We investigated conditions under which BPS is more likely to suppress ADs. Methods: We analyzed parameters altering BPS effectiveness on 200 ADs in seven patients with implanted subdural electrodes. Results: The odds of BPSs stopping ADs was 8.6 times greater at primary sites (directly stimulated electrodes) than at secondary sites (adjacent electrodes) (p = 0.016). BPS applied within 4.5 s after onset of AD had 2 times greater odds of stopping ADs (p = 0.014). BPS applied when AD voltage was negative was 1.9 times more likely to stop ADs (p = 0.012). ADs with rhythmic pattern responded best (p < 0.0001). BPS stopped 100% of ADs not starting immediately after localization stimulus (LS) versus 29% of those starting immediately (p < 0.0001). Conclusions: BPS is more likely to terminate ADs at primary electrodes, if given early, if applied to the negative peak of the AD waveform, if AD has a rhythmic pattern, and if AD did not start immediately after LS.