The immediate and short‐term effects of bilateral intrahippocampal depth electrodes on verbal memory

In contrast to previous studies, Ljung et al. provide evidence of permanent cognitive consequences of bilateral intrahippocampal depth electrodes for verbal memory in patients who were not operated or operated in the right temporal lobe. Stimulated by this, we provide historical confirmatory and supplementary evidence of the detrimental effect of bilateral depth electrodes implanted along the longitudinal axis of the hippocampus on verbal learning and especially on delayed verbal memory and recognition performance. This is demonstrated in 31 patients with memory assessments before implantation, after explantation, and 3 months later after left/right temporal lobe surgery. After surgery, significant recovery from postimplantation impairment is found in right temporal patients. Left temporal resection patients stay on the level seen after implantation and do not recover. Surgery, however, has its own effects in addition to the implantation. Intracranial electrodes for electroencephalographic monitoring or electrical stimulation are commonly and increasingly used for diagnosis or treatment in pharmacoresistant epilepsies. Thus, the monitoring of invasive stereotactic approaches is recommended to find safe procedures for the patients. In response to the findings, we restricted indications and used different implantation schemes, different trajectories, and targets to minimize the risk of additional damage.

[1]  W. Marsh,et al.  Stereotactic electroencephalography with temporal grid and mesial temporal depth electrode coverage: does technique of depth electrode placement affect outcome? , 2010, Journal of neurosurgery.

[2]  C. Elger,et al.  The effect of quantitative and qualitative antiepileptic drug changes on cognitive recovery after epilepsy surgery , 2016, Seizure.

[3]  H. Pall,et al.  Deep brain stimulation of the subthalamic nucleus for advanced Parkinson disease using general anesthesia: long-term results. , 2012, Journal of neurosurgery.

[4]  C. Elger,et al.  Laser interstitial thermotherapy (LiTT) in epilepsy surgery , 2017, Seizure.

[5]  C. Elger,et al.  The overall pathological status of the left hippocampus determines preoperative verbal memory performance in left mesial temporal lobe epilepsy , 2014, Hippocampus.

[6]  Christian E Elger,et al.  Memory Outcome after Selective Amygdalohippocampectomy in Patients with Temporal Lobe Epilepsy: One‐year Follow‐up , 2004, Epilepsia.

[7]  Johan Bengzon,et al.  Verbal memory decline from hippocampal depth electrodes in temporal lobe surgery for epilepsy , 2017, Epilepsia.

[8]  C. Elger,et al.  Safety of Intrahippocampal Depth Electrodes for Presurgical Evaluation of Patients with Intractable Epilepsy , 1997, Epilepsia.

[9]  C. Helmstaedter,et al.  Cognitive outcomes of different surgical approaches in temporal lobe epilepsy , 2013, Epileptic disorders : international epilepsy journal with videotape.

[10]  M. Velasco,et al.  Electrical Stimulation of the Hippocampal Epileptic Foci for Seizure Control: A Double‐Blind, Long‐Term Follow‐Up Study , 2007, Epilepsia.

[11]  J. González-Martínez,et al.  Effect of invasive EEG monitoring on cognitive outcome after left temporal lobe epilepsy surgery , 2015, Neurology.

[12]  G. Vingerhoets,et al.  The cognitive effects of amygdalohippocampal deep brain stimulation in patients with temporal lobe epilepsy , 2011, Epilepsy & Behavior.

[13]  C. Helmstaedter,et al.  Neuropsychologist’s (re-)view: Resective versus ablative amygdalohippocampectomies , 2017, Epilepsy Research.

[14]  Christian E Elger,et al.  Memory Outcome after Selective Amygdalohippocampectomy: A Study in 140 Patients with Temporal Lobe Epilepsy , 2002, Epilepsia.

[15]  M. Brin,et al.  Neuropsychological functioning following bilateral subthalamic nucleus stimulation in Parkinson's disease. , 2004, Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists.

[16]  D. Loring,et al.  Differential neuropsychological outcomes following targeted responsive neurostimulation for partial‐onset epilepsy , 2015, Epilepsia.