Nuria Lacuey1, Bilal Zonjy2, Luisa Londono2, Samden D Lhatoo2. 1. 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. 2. 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.
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.
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.
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