title: Amygdala and hippocampus are symptomatogenic zones for central apneic seizures.
abstract: OBJECTIVE
  To identify limbic sites of respiratory control in the human brain, and by extension, the symptomatogenic zone for central apnea.
  
  
  METHODS
  We used direct stimulation of anatomically, precisely placed stereotactic EEG electrodes to analyze breathing responses. We prospectively studied 3 patients who were explored with stereotactically implanted depth electrodes. The amygdala and hippocampus, as well as extralimbic sites (orbitofrontal, temporal tip, and temporal neocortex), were investigated.
  
  
  RESULTS
  Individual stimulation of the amygdala and hippocampal head consistently elicited central apnea in the expiratory phase, as did exquisitely focal hippocampal seizures.
  
  
  CONCLUSIONS
  These findings confirm that hippocampus and amygdala are limbic breathing control sites in humans, as well as the symptomatogenic zone for central apneic seizures.
authors.affiliation: From the Epilepsy Center (N.L., B.Z., L.L., S.D.L.), UH Cleveland Medical Center, Cleveland, OH; Department of Neurology (N.L.), Vall d 'Hebron University Hospital; Department of Medicine (N.L.), Universitat Autonoma of Barcelona, Spain; and NINDS Center for SUDEP Research (CSR) (S.D.L.), Cleveland, OH. nuria.lacuey@uhhospitals.org.
authors.forename: Nuria
authors.initials: N
authors.lastname: Lacuey
authors.affiliation: From the Epilepsy Center (N.L., B.Z., L.L., S.D.L.), UH Cleveland Medical Center, Cleveland, OH; Department of Neurology (N.L.), Vall d 'Hebron University Hospital; Department of Medicine (N.L.), Universitat Autonoma of Barcelona, Spain; and NINDS Center for SUDEP Research (CSR) (S.D.L.), Cleveland, OH.
authors.forename: Bilal
authors.initials: B
authors.lastname: Zonjy
authors.affiliation: From the Epilepsy Center (N.L., B.Z., L.L., S.D.L.), UH Cleveland Medical Center, Cleveland, OH; Department of Neurology (N.L.), Vall d 'Hebron University Hospital; Department of Medicine (N.L.), Universitat Autonoma of Barcelona, Spain; and NINDS Center for SUDEP Research (CSR) (S.D.L.), Cleveland, OH.
authors.forename: Luisa
authors.initials: L
authors.lastname: Londono
authors.affiliation: From the Epilepsy Center (N.L., B.Z., L.L., S.D.L.), UH Cleveland Medical Center, Cleveland, OH; Department of Neurology (N.L.), Vall d 'Hebron University Hospital; Department of Medicine (N.L.), Universitat Autonoma of Barcelona, Spain; and NINDS Center for SUDEP Research (CSR) (S.D.L.), Cleveland, OH.
authors.forename: Samden D
authors.initials: SD
authors.lastname: Lhatoo
mesh_terms: D000328:Adult; D000679:Amygdala / Q000503:physiopathology*; D001049:Apnea / Q000503:physiopathology*; D001931:Brain Mapping; D000069279:Drug Resistant Epilepsy / Q000503:physiopathology / Q000601:surgery; D004558:Electric Stimulation; D000069280:Electrocorticography; D005260:Female; D006624:Hippocampus / Q000503:physiopathology*; D006801:Humans; D008297:Male; D011300:Preoperative Care; D011446:Prospective Studies; D012119:Respiration; D012640:Seizures / Q000503:physiopathology*