Optimizing parameters for terminating cortical afterdischarges with pulse stimulation

Gholam K. Motamedi, Ronald P. Lesser, Diana L Miglioretti, Yuko Mizuno-Matsumoto, Barry Gordon, William R S Webber, Darryl C. Jackson, Jehuda P. Sepkuty, Nathan E. Crone

Research output: Contribution to journalArticlepeer-review

108 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)836-846
Number of pages11
Issue number8
StatePublished - 2002
Externally publishedYes


  • Afterdischarges
  • Cortical stimulation
  • Electrical stimulation
  • Epilepsy
  • Seizure

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)


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