Boëx Colette, Tyrand Rémi, Horvath Judit, Fleury Vanessa, Sadri Sarvenaz, Corniola Marco, Burkhard Pierre R., Momjian Shahan (2018), What Is the Best Electrophysiologic Marker of the Outcome of Subthalamic Nucleus Stimulation in Parkinson Disease?, in World Neurosurgery
, 120, e1217-e1224.
Bartoli Andrea, TyrandRémi, VargasMaria Isabel, MomjianShahan, BoexColette (2018), Low frequency microstimulation is locally excitatory in patients with epilepsy, in Clinical Neurophysiology
, 12(12), 22.
Tyrand Rémi, Momjian Shahan, Pollo Claudio, Lysakowski Christopher, Lascano Agustina M., Vulliémoz Serge, Schaller Karl, Boëx Colette (2017), Continuous Intraoperative Monitoring of Temporal Lobe Epilepsy Surgery, in Stereotactic and Functional Neurosurgery
, 94(6), 404-412.
Bartoli A (2014), Amygdalo-hippocampal deep brain stimulation for mesial temporal lobe epilepsy, in Clinical Neurophysiology
, 125(S1), S152.
This research project is dedicated to the exploration of the temporal lobe in humans. Beyond the exploration of visual pathways and of language processing for which we participate to other research projects, the present project focused on the exploration of olfaction, memory, epilepsy surgery and neuromodulation of temporal lobe. The intraoperative monitoring of olfaction, will be developped as a new modality in neuromonitoring, to prevent iatrogenic sensory deficits in neurosurgery. The project could also afford to better understanding of primary olfactory cortex in human. The study will be proposed to patients who have to undergo neurosurgical procedure because of temporal or frontal lesion. The exploration of olfactory pathways, of the primary olfactory cortex can be performed intraoperatively and in particular with the exposure of entorhinal cortex. General anaesthesia will be performed under electroencephalogram control (BIS spectral analysis) to ensure appropriate level of cerebral activity with adequate depth of anesthesia. The olfactory stimulation will be performed with chemicals (H2S, CO2). Recordings will be performed with updated methods (e.g. subdermal needles, shielded cables, microelectrode recordings). Signal analyses will include spectral analyses. For some patients with temporal lobe epilepsy, the surgery is still an efficient treatment, but with some neuropsychological risks. We propose to continue to scrutinize intraoperatively the effects of each step of temporal lobe surgery on epileptogenicity. Improvements in understanding of epileptic networks will be achieved by scrutinizing intra-operatively the effects of surgery on epileptogenicity. In the line with pathological studies and surgery outcome analyses, intraoperative neuromonitoring of the epileptiform activity during temporal lobe surgery re-enforces the possibility that the hippocampus is secondary implied in temporal lobe epilepsy. Conversely, superior temporal cortex as well as entorhinal cortex, appear as two important sites. We make the hypotheses that: superior temporal cortex (T1) or entorhinal cortex could appear as new targets for brain stimulation in epilepsy. Randomized entorhinal or superior-temporal gyrus electrical stimulation will contribute to guide future evaluation of chronic stimulation. Effects of stimulation (charge balanced biphasic pulses, for 50 and 130 Hz, monopolar) will be measured with interictal epileptiform discharge rates, with evoked potentials and microelectrode recordings. The entorhinal cortex will be evaluated for memory enhancement. The changes in implicit and explicit memory will be evaluated with neuropsychological tests (hits with priming for implicit memory, delayed recall for explicit memory). This study will afford to evaluate entorhinal stimulation as a target for memory enhancement. This could open new insights in palliative treatments of Alzheimer’s disease or of hippocampal sclerosis with dementia, improving the quality of life of patients.