Evidence map›Paper›PMID 36127246›Full record

ArticleClinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology2023

Cortico-cortical evoked potentials in response to varying stimulation intensity improves seizure localization.

Mark A Hays, Rachel J Smith, Yujing Wang, Christopher Coogan, Sridevi V Sarma, Nathan E Crone, Joon Y Kang

Open access · greenAbstract read
In one paragraph

Article in Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 1 pooled it
2.7field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
  4. A guide to neuromodulation in drug-resistant epilepsy.Epileptic disorders : international epilepsy journal with videotape · 2026
    Review
  5. Optimization of cortico-cortical spectral response analysis parameters for seizure onset zone localization.Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology · 2026
    Article
  6. Adaptation modulates effective connectivity and network stability.Frontiers in computational neuroscience · 2026
    Article
  7. Review
  8. Review
  9. Review
  10. Anti-Hu associated paraneoplastic upper and lower motor neuropathy triggered by atezolizumab.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2024
    Article
  11. Article
  12. Network excitability of stimulation-induced spectral responses helps localize the seizure onset zone.Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology · 2024
    Article
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Mark A HaysDepartment of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address: mhays6@jhmi.edu.
Rachel J SmithDepartment of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD, USA.
Yujing WangDepartment of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Christopher CooganDepartment of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Sridevi V SarmaDepartment of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD, USA.
Nathan E CroneDepartment of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Joon Y KangDepartment of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Johns Hopkins Medicine · USJohns Hopkins University · US

Funding

Diagnostic validity and safety of high-gamma language mapping with intracranial EEGR01NS115929 · NINDS · JOHNS HOPKINS UNIVERSITY · PI Ravindra Arya, NATHAN E CRONE · 2020 to 2026
$3.9M
NINDS NIH HHS R01 NS115929
6 · The paper itself

Abstract

objectiveAs single pulse electrical stimulation (SPES) is increasingly utilized to help localize the seizure onset zone (SOZ), it is important to understand how stimulation intensity can affect the ability to use cortico-cortical evoked potentials (CCEPs) to delineate epileptogenic regions.

methodsWe studied 15 drug-resistant epilepsy patients undergoing intracranial EEG monitoring and SPES with titrations of stimulation intensity. The N1 amplitude and distribution of CCEPs elicited in the SOZ and non-seizure onset zone (nSOZ) were quantified at each intensity. The separability of the SOZ and nSOZ using N1 amplitudes was compared between models using responses to titrations, responses to one maximal intensity, or both.

resultsAt 2 mA and above, the increase in N1 amplitude with current intensity was greater for responses within the SOZ, and SOZ response distribution was maximized by 4-6 mA. Models incorporating titrations achieved better separability of SOZ and nSOZ compared to those using one maximal intensity.

conclusionsWe demonstrated that differences in CCEP amplitude over a range of current intensities can improve discriminability of SOZ regions. SIGNIFICANCE: This study provides insight into the underlying excitability of the SOZ and how differences in current-dependent amplitudes of CCEPs may be used to help localize epileptogenic sites.

Indexed as

Drug Resistant EpilepsyElectrocorticographyElectric StimulationElectroencephalographyEvoked PotentialsHumansSeizuresCortico-cortical evoked potentialEffective connectivityEpilepsyEpileptogenic networkintracranial EEGSingle pulse electrical stimulation

Identifiers

PMID36127246
PMCPMC9771930
OpenAlexW4295136077

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.