Parameters for direct cortical electrical stimulation in the human: histopathologic confirmation.
Safe parameters for electrical cortical stimulation in humans are difficult to estimate from the animal experimental literature. We therefore examined the light microscopic histology at a total of 11 sites of direct subdural electrical stimulation, taken as part of anterior temporal lobectomies in 3 patients. Stimulations had been done through 3.175 mm diameter electrodes, with 0.3 msec square wave pulses of alternating polarity at 50 pulses/sec. In 2 patients, one site each had been used as a common reference for stimulation, receiving over 251 stimulation trials, most of 2-5 sec duration, at currents of 12.5-15.0 mA, 1 day prior to resection. The maximum charge per phase was 4.0-4.4 microC; the maximum charge density was 52-57 microC per geometric cm2 per pulse at the electrode surfaces. Comparison of hematoxylin and eosin, periodic acid-Schiff, and cresyl violet-stained material from the electrode sites with that from other regions did not show any histologic abnormalities attributable to the electrical stimulation. The relatively brief and intermittent periods utilized for human stimulation testing do not appear to cause structural damage at the light microscopic level at charge densities that exceed the threshold for damage established in animal studies with more continuous, chronic stimulation schedules.
Epilepsy Center, Johns Hopkins University School of Medicine, Baltimore, MD 21205.
B
B
Gordon
R P
RP
Lesser
N E
NE
Rance
J
J
Hart
R
R
Webber
S
S
Uematsu
R S
RS
Fisher
D004558:Electric Stimulation / Q000009:adverse effects / Q000379:methods; D004566:Electrodes; D004833:Epilepsy, Temporal Lobe / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery; D005911:Gliosis / Q000473:pathology; D006801:Humans; D013346:Subarachnoid Space / Q000473:pathology; D013702:Temporal Lobe / Q000473:pathology* / Q000502:physiology