• Chie Kamada, Rei Enatsu, Seiichiro Imataka, Aya Kanno, Satoko Ochi, and Nobuhiro Mikuni.
• Department of Neurosurgery, Sapporo Medical University, Sapporo, Japan.
• World Neurosurg. 2024 Aug 1; 188: e288e296e288-e296.

ObjectiveThis study investigated the neurologic symptoms and stimulus intensities in the stimulation of deep structures and subcortical fibers with the depth electrodes.MethodsSeventeen patients with drug-refractory epilepsy who underwent functional brain mapping with the depth electrodes were enrolled. The 50 Hz electrical stimulation was applied, and the diffusion tensor image was used to identify subcortical fibers. The responsible structures and stimulus intensities for the induced neurologic symptoms were evaluated.ResultsNeurologic symptoms were induced in 11 of 17 patients. The opercular stimulation elicited the neurologic symptoms in 6 patients at the median threshold of 4.0 mA (visceral/face/hand sensory, hand/throat motor, negative motor and auditory symptoms). The insular stimulation induced the neurologic symptoms in 4 patients at the median threshold of 4.0 mA (auditory, negative motor, and sensory symptoms). The stimulation of subcortical fibers was induced in 5 of 9 patients at the median threshold of 4.5 mA. The thresholds of depth electrodes were significantly lower than those of subdural electrodes in 8 patients who used both subdural and depth electrodes and induced symptoms with both electrodes.ConclusionsThe stimulation of depth electrodes can identify the function of deep structures and subcortical fibers with lower intensities than subdural electrodes.Copyright © 2024 Elsevier Inc. All rights reserved.

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