Brief bursts of pulse stimulation terminate afterdischarges caused by cortical stimulation

R. P. Lesser, S. H. Kim, L. Beyderman, Diana L Miglioretti, W. R S Webber, M. Bare, B. Cysyk, G. Krauss, B. Gordon

Research output: Contribution to journalArticle

196 Citations (Scopus)

Abstract

Objective: To determine whether cortical electrical stimulation can terminate bursts of epileptiform activity in humans, we used afterdischarges (ADs) as a model of epileptiform activity. Methods: Cortical stimulation was performed for clinical localization purposes using subdural electrodes implanted in patients undergoing preresection evaluations for treatment of medically intractable seizures. We used 0.3-millisecond pulses of alternating polarity, repeated at 50 pulses/second. When stimulation produced AD, we often applied short additional brief bursts of pulse stimulation (BPS). We examined the effectiveness of BPS in aborting ADs in 17 patients using survival analysis. Results: With BPS, ADs stopped within 2 seconds in 115 cases, 2 to 5 seconds in 22 cases, and in more than 5 seconds in 89 cases. Without BPS, ADs stopped within 2 seconds in 21 cases, 2 to 5 seconds in 114 cases, and in more than 5 seconds in 340 cases. BPS was an effective method to abort ADs (Cox proportional hazards model: p < 0.0001). At any time during the course of ADs, the instantaneous rate of stopping ADs within 2 seconds after BPS was applied was 4.6 times greater than when BPS was not applied (95% CI = 3.7, 5.7). In eight cases, ADs progressed to the occurrence of clinical seizures, always when BPS was not applied. Conclusions: Afterdischarges significantly decreased in duration after we applied brief bursts of pulse stimulation. Although afterdischarges are not identical to spontaneous epileptiform activity, these results support the idea that electrical stimulation, applied in an appropriate manner at seizure onset, could abort seizures in humans.

Original languageEnglish (US)
Pages (from-to)2073-2081
Number of pages9
JournalNeurology
Volume53
Issue number9
StatePublished - Dec 10 1999
Externally publishedYes

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Seizures
Electric Stimulation
Implanted Electrodes
Survival Analysis
Proportional Hazards Models
Human Activities
Therapeutics

Keywords

  • Afterdischarges
  • Epilepsy
  • Seizures
  • Stimulation

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Lesser, R. P., Kim, S. H., Beyderman, L., Miglioretti, D. L., Webber, W. R. S., Bare, M., ... Gordon, B. (1999). Brief bursts of pulse stimulation terminate afterdischarges caused by cortical stimulation. Neurology, 53(9), 2073-2081.

Brief bursts of pulse stimulation terminate afterdischarges caused by cortical stimulation. / Lesser, R. P.; Kim, S. H.; Beyderman, L.; Miglioretti, Diana L; Webber, W. R S; Bare, M.; Cysyk, B.; Krauss, G.; Gordon, B.

In: Neurology, Vol. 53, No. 9, 10.12.1999, p. 2073-2081.

Research output: Contribution to journalArticle

Lesser, RP, Kim, SH, Beyderman, L, Miglioretti, DL, Webber, WRS, Bare, M, Cysyk, B, Krauss, G & Gordon, B 1999, 'Brief bursts of pulse stimulation terminate afterdischarges caused by cortical stimulation', Neurology, vol. 53, no. 9, pp. 2073-2081.
Lesser RP, Kim SH, Beyderman L, Miglioretti DL, Webber WRS, Bare M et al. Brief bursts of pulse stimulation terminate afterdischarges caused by cortical stimulation. Neurology. 1999 Dec 10;53(9):2073-2081.
Lesser, R. P. ; Kim, S. H. ; Beyderman, L. ; Miglioretti, Diana L ; Webber, W. R S ; Bare, M. ; Cysyk, B. ; Krauss, G. ; Gordon, B. / Brief bursts of pulse stimulation terminate afterdischarges caused by cortical stimulation. In: Neurology. 1999 ; Vol. 53, No. 9. pp. 2073-2081.
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