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Master Thesis

Clinical effects of direct cortical stimulation of the human brain and proposal for a functional atlas

Abstract : For almost one century, direct cortical stimulation (DCS) has appeared as a powerful technique to map brain functions in epilepsy surgery and tumor surgery patients. This has provided a large amount of data on the key structures involved in various perceptual and behavioral phenomena which are, however, very difficult to synthesize and therefore uneasy to use. The aim of our work was to assess the feasibility to generate a functional atlas from DCS-derived clinical data, including video clips. This atlas was imagined to be symptom-based and anatomically-based, both at the individual and group level, in order to be usable for students, clinicians and researchers. To do so, 1642 clinical responses (DCS-R) elicited by 1436 stimulations applied at 1007 cortical sites were extracted from DCS performed in 50 epilepsy surgery candidates submitted to Stereotactic intracerebral EEG (SEEG) investigation. Data were carefully analysed to provide information on the stimulated dipole, stimulation parameters, DCS-R (classified according to Lüders's classification) and SEEG changes. Video-SEEG segments of DCS-R were extracted from the video-SEEG files to provide the full clinical information. Anatomical description of the patients' brains were extracted from the database generated by the IntrAnat Electrode sofware that we use in routine. Data were anonymized and coded before to be further processed. We then used two already existing in-house softwares (HIBoP and BrainTVreplay) developed by the Centre de Recherche en Neurosciences de Lyon to link together anatomical and SEEG data and review video sequences. Our premiminary results shows that the atlas allows, both at the individual and group level, and with a video output, a convenient 3D visualization of the cortical networks associated with similar DCS-R, as well as of all DCS-R elicited from a given cortical parcel. A tutorial has been elaborated to help future users to export DCS-R in HIBoP, from where they can be easily displayed on brain anatomy, and further visualized using BrainTVreplay. We expect this preliminary work to provide convincing arguments on the practicality and interest of this proof-of-concept of atlas, that will need further improvements to make it available in routine. We assume that the present dataset, while limited, already provides a firm basis for a collaborative effort across epilepsy surgery centers to update the atlas over time.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03469116
Contributor : Jean-Hugues Morneau Connect in order to contact the contributor
Submitted on : Tuesday, December 7, 2021 - 3:00:59 PM
Last modification on : Saturday, January 1, 2022 - 3:33:23 AM

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  • HAL Id : dumas-03469116, version 1
  • PPN : 249215624

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Thomas Rieffel. Clinical effects of direct cortical stimulation of the human brain and proposal for a functional atlas. Human health and pathology. 2020. ⟨dumas-03469116⟩

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