University of Copenhagen, Clinical Medicine, Copenhagen, Denmark; Zealand University Hospital, Department of Neurology, Roskilde, Denmark; Stanford University, Department of Neurology, Palo Alto, CA USA.
NeuroPace, Inc., Mountain View, CA, USA.
Clin Neurophysiol. 2021 Jun;132(6):1209-1220. doi: 10.1016/j.clinph.2021.03.013. Epub 2021 Mar 31.
Understanding the acute effects of responsive stimulation (AERS) based on intracranial EEG (iEEG) recordings in ambulatory patients with drug-resistant partial epilepsy, and correlating these with changes in clinical seizure frequency, may help clinicians more efficiently optimize responsive stimulation settings.
In patients implanted with the NeuroPace® RNS® System, acute changes in iEEG spectral power following active and sham stimulation periods were quantified and compared within individual iEEG channels. Additionally, acute stimulation-induced acute iEEG changes were compared within iEEG channels before and after patients experienced substantial reductions in clinical seizure frequency.
Responsive stimulation resulted in a 20.7% relative decrease in spectral power in the 2-4 second window following active stimulation, compared to sham stimulation. On several detection channels, the AERS features changed when clinical outcomes improved but were relatively stable otherwise. AERS change direction associated with clinical improvement was generally consistent within detection channels.
In this retrospective analysis, patients with drug-resistant partial epilepsy treated with direct brain-responsive neurostimulation showed an acute stimulation related reduction in iEEG spectral power that was associated with reductions in clinical seizure frequency.
Identifying favorable stimulation related changes in iEEG activity could help physicians to more rapidly optimize stimulation settings for each patient.
了解基于颅内 EEG(iEEG)记录的反应性刺激(AERS)对耐药性部分性癫痫患者的急性影响，并将其与临床癫痫发作频率的变化相关联，这可能有助于临床医生更有效地优化反应性刺激设置。
在植入 NeuroPace®RNS®系统的患者中，量化并比较了在个体 iEEG 通道中主动和假刺激期间 iEEG 频谱功率的急性变化。此外，在患者经历临床癫痫发作频率显著降低之前和之后，比较了 iEEG 通道内的急性刺激诱导的急性 iEEG 变化。
与假刺激相比，主动刺激后 2-4 秒窗口内的频谱功率相对减少了 20.7%。在几个检测通道上，当临床结果改善时，AERS 特征发生了变化，但在其他情况下相对稳定。与临床改善相关的 AERS 变化方向在检测通道内通常是一致的。
在这项回顾性分析中，接受直接脑反应性神经刺激治疗的耐药性部分性癫痫患者表现出 iEEG 频谱功率的急性刺激相关降低，这与临床癫痫发作频率的降低相关。
识别 iEEG 活动中有利的刺激相关变化可以帮助医生更快速地为每个患者优化刺激设置。
