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The prospective study aims to characterize the network-specific modulatory effects of piriform cortex stimulation in patients undergoing stereotactic EEG for drug-resistant epilepsy. Using multimodal data, it seeks to link stimulation-evoked electrophysiological responses across brain networks with clinical outcomes, to inform targeted neuromodulation therapies.
This study employs stereotactic electroencephalography (SEEG) to investigate the network-specific mechanisms of brain modulation induced by electrical stimulation of the piriform cortex. By analyzing high-density intracranial recordings, combined with structural and functional neuroimaging, the research systematically characterizes how focal stimulation differentially engages and reorganizes activity across large-scale neural circuits. The primary focus is to decode the electrophysiological signatures of network engagement-including changes in spectral power, phase synchronization, and information flow-to reveal fundamental principles of targeted neuromodulation in the human brain.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| SEEG recordings and SPES effects | Experimental | This arm encompasses patients with drug-resistant focal epilepsy who underwent intracranial monitoring via stereotactically implanted depth electrodes (SEEG) as part of their standard presurgical evaluation. During the monitoring period, these patients additionally underwent systematic Single-Pulse Electrical Stimulation (SPES) mapping. SPES was administered according to a standardized clinical protocol, involving the delivery of single, low-intensity electrical pulses to selected electrode contacts-including those located within or adjacent to the piriform cortex-while recording the evoked electrophysiological responses across the implanted SEEG network. The data collected in this arm include continuous intracranial EEG recordings, precise stimulation parameters (location, intensity), and the corresponding electrophysiological responses used to characterize cortico-cortical evoked potentials and network connectivity. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| SEEG recordings and SPES | Device | The intervention involves single-pulse electrical stimulation (SPES) applied during stereotactic electroencephalography (SEEG) monitoring. Low-intensity, standardized electrical pulses are delivered to targeted contacts within or near the piriform cortex via implanted depth electrodes, while simultaneous full-bandwidth SEEG recordings capture network-wide electrophysiological responses, allowing characterization of stimulation-evoked brain network activation and modulation patterns. |
| Measure | Description | Time Frame |
|---|---|---|
| Seizure Discharge Suppression Rate | Quantified as the percentage reduction in the frequency of spikes and interictal epileptiform discharges (IEDs) during active stimulation compared to the baseline period. | 72 hours |
| Measure | Description | Time Frame |
|---|---|---|
| Single-Pulse Stimulation Amplitude: | The minimum current intensity (mA) required to elicit a reproducible response. | 72 hours |
| N1 Component Amplitude and Latency: | Amplitude (μV) and latency (ms) of the primary cortical evoked response (N1 wave). |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Liankun Ren, MD | Contact | 13681576621 | renlk2022@outlook.com |
| Name | Affiliation | Role |
|---|---|---|
| Liankun Ren | Xuanwu Hospital, Beijing | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Xuanwu Hospital | Beijing | Beijing Municipality | 100053 | China |
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| ID | Term |
|---|---|
| D000069279 | Drug Resistant Epilepsy |
| ID | Term |
|---|---|
| D004827 | Epilepsy |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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| 72 hours |
| Spatial Distribution of Activation | The extent of cortical activation, assessed by the number of electrode contacts showing significant evoked responses. | 72 hours |
| Effective Connectivity Changeļ¼ | Alterations in effective connectivity strength (e.g., measured by Granger causality within a 500 ms time window). | 72 hours |
| Phase-Amplitude Coupling Index | Changes in coupling between the phase of low-frequency oscillations and the amplitude of the gamma band (30-80 Hz). | 72 hours |
| Functional Network Reconfiguration | Changes in node centrality metrics (e.g., betweenness centrality, degree centrality) based on graph-theoretical analysis of functional networks. | 72 hours |
| Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability] | Adverse Events: Incidence and severity of adverse events specifically associated with piriform cortex stimulation. | 72 hours |