A safe and effective paradigm to functionally map the cortex in childhood

P. Jayakar, L. A. Alvarez, M. S. Duchowny, T. J. Resnick

Research output: Contribution to journalArticle

104 Scopus citations

Abstract

Conventional cortical stimulation based on pulses of fixed duration briefer than the chronaxie rarely elicit responses in infants and young children. We developed a stimulation paradigm that relies on increments in both stimulus intensity and pulse duration. This approach ensures that stimulation parameters converge to the chronaxie by mathematically minimizing the energy required to elicit a response. In six patients, this paradigm successfully elicited clinical responses and/or after discharges at thresholds 5-8 mA below the standard paradigm and at up to 64% lower energy levels. Furthermore, three patients under age 5 years who did not respond to maximal fixed duration stimulation demonstrated after discharges and clinical responses when longer pulse durations were utilized. These findings indicate that a paradigm based on dual increments is effective for cortical mapping in children. Furthermore, by ensuring responses at lower energy levels, it may be more efficient for mapping the cortex at all ages.

Original languageEnglish (US)
Pages (from-to)288-293
Number of pages6
JournalJournal of Clinical Neurophysiology
Volume9
Issue number2
DOIs
StatePublished - Apr 1992

Keywords

  • Children
  • Functional cortical mapping

ASJC Scopus subject areas

  • Physiology
  • Neurology
  • Clinical Neurology
  • Physiology (medical)

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