Effects of amygdala–hippocampal stimulation on interictal epileptic discharges

Tyrand, R.; Seeck, M.; Spinelli, L.; Pralong, E.; Vulliémoz, S.; Foletti, G.; Rossetti, A.O.; Allali, G.; Lantz, G.; Pollo, C.; Boëx, C.

doi:10.1016/j.eplepsyres.2011.10.026

« Previous Next »Epilepsy Research
Volume 99, Issue 1 , Pages 87-93, March 2012

Effects of amygdala–hippocampal stimulation on interictal epileptic discharges

R. Tyrand
- Department of Neurology, University Hospital of Geneva, CH-1211 Genèva 14, Switzerland
M. Seeck
- Department of Neurology, University Hospital of Geneva, CH-1211 Genèva 14, Switzerland
L. Spinelli
- Department of Neurology, University Hospital of Geneva, CH-1211 Genèva 14, Switzerland
E. Pralong
- Department of Neurosurgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
S. Vulliémoz
- Department of Neurology, University Hospital of Geneva, CH-1211 Genèva 14, Switzerland
G. Foletti
- Department of Neurology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
A.O. Rossetti
- Department of Neurology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
G. Allali
- Department of Neurology, University Hospital of Geneva, CH-1211 Genèva 14, Switzerland
G. Lantz
- Department of Neurology, University Hospital of Geneva, CH-1211 Genèva 14, Switzerland
C. Pollo
- Department of Neurosurgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
C. Boëx
- Department of Neurology, University Hospital of Geneva, CH-1211 Genèva 14, Switzerland
- Corresponding author. Tel.: +41 0 22 372 52 59; fax: +41 0 22 372 84 75.

Received 24 June 2011; received in revised form 14 October 2011; accepted 16 October 2011. published online 14 November 2011.

Summary

Deep brain stimulation (DBS) of different nuclei is being evaluated as a treatment for epilepsy. While encouraging results have been reported, the effects of changes in stimulation parameters have been poorly studied. Here the effects of changes of pulse waveform in high frequency DBS (130Hz) of the amygdala–hippocampal complex (AH) are presented. These effects were studied on interictal epileptic discharge rates (IEDRs).

AH-DBS was implemented with biphasic versus pseudo monophasic charge balanced pulses, in two groups of patients: six with temporal lobe epilepsy (TLE) associated with hippocampal sclerosis (HS) and six with non lesional (NLES) temporal epilepsy.

In patients with HS, IEDRs were significantly reduced with AH-DBS applied with biphasic pulses in comparison with monophasic pulse. IEDRs were significantly reduced in only two patients with NLES independently to stimulus waveform.

Comparison to long-term seizure outcome suggests that IEDRs could be used as a neurophysiological marker of chronic AH-DBS and they suggest that the waveform of the electrical stimuli can play a major role in DBS. We concluded that biphasic stimuli are more efficient than pseudo monophasic pulses in AH-DBS in patients with HS. In patients with NLES epilepsy, other parameters relevant for efficacy of DBS remain to be determined.

Keywords: DBS, Epilepsy, Temporal lobe