Quantifying volume conducted potential using stimulation artefact in cortico-cortical evoked potentials.

Background: Cortico-cortical evoked potentials (CCEP) are a technique using low frequency stimulation to infer regions of cortical connectivity in patients undergoing Stereo-electroencephalographic (SEEG) monitoring for refractory epilepsy. Little attention has been given to volume conducted components of CCEP responses, and how they may inflate CCEP connectivity.

New Method: Using data from 37 SEEG-CCEPs patients, a novel method was developed to quantify stimulation artefact by measuring the peak-to-peak voltage difference in the first 10 ms after CCEP stimulation.

Comparing connectivity metrics in cortico-cortical evoked potentials using synthetic cortical response patterns.

Background: Cortico-Cortical Evoked Potentials (CCEPs) are a novel low frequency stimulation method used for brain mapping during intracranial epilepsy investigations. Only a handful of metrics have been applied to CCEP data to infer connectivity, and no comparison as to which is best has been performed.

New Method: We implement a novel method which involved superimposing synthetic cortical responses onto stereoelectroencephalographic (SEEG) data, and use this to compare several metric's ability to detect the simulated patterns.

Automatic detection of the epileptogenic zone: An application of the fingerprint of epilepsy.

Background: The successful delineation of the epileptogenic zone in epilepsy monitoring is crucial for achieving seizure freedom after epilepsy surgery.

New Method: We aim to improve epileptogenic zone localization by utilizing a computer-assisted tool for the automated grading of the seizure activity recorded in various locations for 20 patients undergoing stereo electroencephalography. Their epileptic seizures were processed to extract two potential biomarkers.

Nocturnal motor events in epilepsy: Is there a defined physiological network?

Objective: Paroxysmal nocturnal movements in epilepsy are a recognised phenomenon, however, the mechanisms that produce them and the effect of the underlying epilepsy still remains elusive. In this study, 10 patients were studied to define the cerebral networks corresponding to these movements and explore how epileptiform activity modulated them.

Methods: We compared the change in power of the 25-250 Hz frequency band using event-related synchronization of all stereo-EEG electrodes implanted, during a baseline segment, during nocturnal movements and seizures.

Considerations in performing and analyzing the responses of cortico-cortical evoked potentials in stereo-EEG.

This review aims to highlight key considerations when performing cortico-cortical evoked potentials (CCEPs) using stereo-electroencephalography (SEEG) for network mapping and show its clinical applicability to presurgical evaluations. The parameters for performing stimulation and safety aspects have been investigated in electrocorticography (ECoG) and deep brain stimulation (DBS), but not as extensively in SEEG. A review of current literature was performed, with an attempt made to emphasize practical insights from all modalities of intracranial stimulation.

Physiological response of the human pancreas to enteral and parenteral feeding.

Purpose Of Review: Normal digestive physiology is a highly orchestrated process, integrating the mechanical breakdown of food, the secretion of digestive juices, the control of motility, and the efficient absorption of nutrients. As enteral and parenteral feeding techniques bypass many of these control mechanisms, nutritional utilization can be expected to be disturbed. This review examines recent publications that have investigated this question in clinical practice.