Al-Sadek Tamara, Wadhwa Aryan, Wadhwa Millen, Warren Aaron E L, Rolston John D
Department of Electrical and Computer Engineering, Maroun Semaan Faculty of Engineering and Architecture, American University of Beirut, Beirut, Lebanon.
Department of Neurosurgery, Mass General Brigham, Harvard Medical School, Boston, MA, United States.
Front Hum Neurosci. 2025 Sep 1;19:1636115. doi: 10.3389/fnhum.2025.1636115. eCollection 2025.
Cortico-cortical evoked potentials (CCEPs) are electrophysiological responses elicited by direct electrical stimulation of one cortical region and recorded from another, providing insights into functional connectivity and communication pathways between brain areas. However, no consistent standard for defining and measuring CCEPs currently exists.
We conducted a systematic review of the CCEP literature on detection methods to evaluate commonalities and gaps in methodology. Extracted data included demographics, disease, recording type, montage, recording system, stimulation amplitude and frequency, time window used for epoching around stimulus onset, open access availability, and detection approach.
Of 187 studies undergoing full-text review, over half lacked a description of the CCEP detection method. Specifically, 9.1% utilized visual identification, whereas 49.74% did not explicitly state the method. The remaining 72 studies represented 3,424 patients, of whom 58.3% had sEEG electrodes and most had epilepsy. The most common detection method was threshold-based (68.1%), followed by statistical testing (16.7%) to determine whether CCEPs differed significantly from baseline, data-driven methods (4.1%) that quantify responses after learning from data, and frequency-based approaches (4.1%). Bipolar (48.6%) and single-electrode referential montages (18.1%) were most frequently employed.
Current CCEP detection methods lack consensus, with many studies omitting methodological details and relying heavily on threshold-based techniques that assume fixed response shapes. Future research should encourage the use of data-driven approaches, which learn directly from data, offer more robust alternatives, and improve quantification in both clinical and research contexts.
https://www.crd.york.ac.uk/PROSPERO/view/CRD42024568261, identifier CRD42024568261.
皮质-皮质诱发电位（CCEPs）是通过直接电刺激一个皮质区域并从另一个区域记录到的电生理反应，可深入了解脑区之间的功能连接和通信通路。然而，目前尚无定义和测量CCEPs的一致标准。
我们对CCEP文献中关于检测方法进行了系统综述，以评估方法学上的共性和差距。提取的数据包括人口统计学、疾病、记录类型、导联组合、记录系统、刺激幅度和频率、刺激开始前后用于分段的时间窗、开放获取的可用性以及检测方法。
在接受全文审查的187项研究中，超过一半缺乏对CCEP检测方法的描述。具体而言，9.1%采用视觉识别，而49.74%未明确说明方法。其余72项研究涉及3424例患者，其中58.3%有立体脑电图电极，且大多数患有癫痫。最常见的检测方法是基于阈值的方法（68.1%），其次是统计检验（16.7%）以确定CCEPs是否与基线有显著差异，数据驱动方法（4.1%）从数据中学习后量化反应，以及基于频率的方法（4.1%）。最常采用的是双极导联组合（48.6%）和单电极参考导联组合（18.1%）。
当前CCEP检测方法缺乏共识，许多研究省略了方法学细节，严重依赖基于阈值的技术，而这些技术假定反应形状固定。未来研究应鼓励使用数据驱动方法，这种方法直接从数据中学习，提供更稳健的替代方案，并改善临床和研究环境中的量化。
https://www.crd.york.ac.uk/PROSPERO/view/CRD42024568261，标识符CRD42024568261。
