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Gamma-oscillations from bench to bed


Grunwald, T; Sarnthein, J (2012). Gamma-oscillations from bench to bed. Clinical Neurophysiology, 123(10):1897-1898.

Abstract

In the presurgical evaluation of patients with pharmacoresistant epilepsies, the borders between disciplines tend to oscillate. In particular, the necessity to evaluate the functional capacity of a cortical area that has been shown to be epileptogenic and is thus being considered for resection often makes it impossible not to trespass between neurophysiology and neuropsychology. In epilepsy surgery, the principle of “first, do no harm”, often blurs the distinction between “bed and bench”: findings from basic sciences that implicate a certain brain region in specific neurological or neuropsychological functions must be taken into account when an elective resection of a structure is considered – even if resection might relieve the patient from frequent intolerable seizures. That may seem to go without saying and, in fact, several examinations that are used routinely in modern presurgical evaluation are really shortcuts in the path from bench to bed. It may be an excuse that there are still are no generally accepted protocols for examinations such as the intracarotid amobarbital (“Wada”) test or language mapping by electro-stimulation, be the latter intrasurgical or by chronically implanted subdural electrodes. On the other hand, the opposite way “from bed to bench and back” has a famous history in epilepsy surgery: a new area of memory research followed Brenda Milner’s analysis of the famous anterograde amnesia caused by the resection of both hippocampi in Henry Molaison (H.M.) and, eventually, this has led to important clinical applications in both neuropsychology and neurophysiology.

In the presurgical evaluation of patients with pharmacoresistant epilepsies, the borders between disciplines tend to oscillate. In particular, the necessity to evaluate the functional capacity of a cortical area that has been shown to be epileptogenic and is thus being considered for resection often makes it impossible not to trespass between neurophysiology and neuropsychology. In epilepsy surgery, the principle of “first, do no harm”, often blurs the distinction between “bed and bench”: findings from basic sciences that implicate a certain brain region in specific neurological or neuropsychological functions must be taken into account when an elective resection of a structure is considered – even if resection might relieve the patient from frequent intolerable seizures. That may seem to go without saying and, in fact, several examinations that are used routinely in modern presurgical evaluation are really shortcuts in the path from bench to bed. It may be an excuse that there are still are no generally accepted protocols for examinations such as the intracarotid amobarbital (“Wada”) test or language mapping by electro-stimulation, be the latter intrasurgical or by chronically implanted subdural electrodes. On the other hand, the opposite way “from bed to bench and back” has a famous history in epilepsy surgery: a new area of memory research followed Brenda Milner’s analysis of the famous anterograde amnesia caused by the resection of both hippocampi in Henry Molaison (H.M.) and, eventually, this has led to important clinical applications in both neuropsychology and neurophysiology.

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Additional indexing

Item Type:Journal Article, refereed, further contribution
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Neurology
04 Faculty of Medicine > University Hospital Zurich > Clinic for Neurosurgery
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:October 2012
Deposited On:15 Feb 2013 15:50
Last Modified:05 Apr 2016 16:28
Publisher:Elsevier
ISSN:1388-2457
Publisher DOI:https://doi.org/10.1016/j.clinph.2012.02.083
PubMed ID:22503905
Permanent URL: https://doi.org/10.5167/uzh-72863

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