Cortical Excitability Assessment Using Paired Pulses

Cortical Excitability Assessment of Pharmacoresistant Focal Epilepsy Using Direct Electrical Stimulation During Stereo-electroencephalography

Status

UNKNOWN

Phases

Study type

Interventional

Source

ClinicalTrials.gov

Registry ID

NCT02245061

Acronym

Enrollment

Registered

2014-09-19

Start date

2014-09-09

Completion date

2021-09-30

Last updated

2019-10-23

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Focal Epilepsy

Keywords

pharmacoresistant focal epilepsy, cortical excitability, paired pulses, TMS, SEEG, DES

Brief summary

The identification of the epileptogenic zone (EZ) during pharmacoresistant focal epilepsy presurgical assessment frequently requires intracranial recordings like stereo-electroencephalography (SEEG). Cortical direct electrical stimulation (DES) is commonly used during SEEG for functional mapping or to induce seizure. However, the recording of seizures is sometimes insufficient to circumscribe the EZ and development of new biomarkers is necessary. The cortex within the EZ is thought to be hyperexcitable. The paired pulses paradigm, using transcranial magnetic stimulation (TMS), allows determining the hemispheric cortical excitability level. The investigators hypothesize that paired pulses DES during SEEG could provide useful information for EZ identification.

Interventions

OTHERpaired pulses cortical electrical stimulation

Study design

Allocation

Intervention model

SINGLE_GROUP

Primary purpose

DIAGNOSTIC

Masking

NONE

Eligibility

Sex/Gender

ALL

Age

18 Years to No maximum

Healthy volunteers

Inclusion criteria

* Age above 18 years old * Pharmacoresistant focal epilepsy patients undergoing a stereo-electroencephalographic recording * Provide written consent to the study after receiving clear information * Be a beneficiary or member of health insurance plan

Exclusion criteria

Patient with contraindication for MRI scanning * Pregnancy * Prohibition on participation in other research, apart from any other non-interventional research

Design outcomes

Primary

Measure	Time frame	Description
Presence of a significant difference between the evoked responses to paired pulses cortical electrical stimulation of epileptogenic zone cortex and of normal cortex	between Day 7 and 21 (End of the stereoelectroencephalographic recordings)	Low frequency single pulse electrical stimulation induces several cortico-cortical electroencephalographic responses: early-physiological and/or late-pathological. We expect different paired pulses modulation of those responses according the excitability level of the stimulated cortex (in terms of latency, amplitude, surface, frequency power)

Secondary

Measure	Time frame
Presence of a difference of responses patterns between anatomic regions and/or lesion type	between Day 7 and 21 (End of the stereoelectroencephalographic recordings )
Presence of a difference between transcranial magnetic paired pulses stimulations and intracranial paired pulses cortical direct electrical stimulations	Between Day 7 and 21 (End of the stereoelectroencephalographic recordings)

Countries

France

Contacts

Primary ContactSylvain RHEIMS, MD

sylvain.rheims@univ-lyon1.fr4 17 30 60 64

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026