Novel Paradigm of Subdural Cortical Stimulation Does Not Cause Thermal Damage in Brain Tissue: A Simulation-Based...

The thermal effect of a novel effective electrical stimulation mapping (ESM) technique using an Ojemann's stimulation electrode in open craniotomy areas causes a nondestructive local increase in temperature. Another type of stimulating electrode is a subdural strip, routinely used in intraoperative electrocorticography (ECoG), which applies ESM in a covered subdural area over the motor cortex. ECoG electrode geometry produces a different electrical field, causing a different Joule heat distribution in tissue, one that is impossible to measure in subdural space. Therefore, the previous safety control study of the novel ESM technique needed to be extended to include an assessment of the thermal effect of ECoG strip electrodes. We adapted a previously well-validated numerical model and performed coupled complex electro-thermal transient simulations for short-time (28.4 ms) high-frequency (500 Hz) and hyperintense (peak 100 mA) ESM paradigm. The risk of heat-induced cellular damage was assessed by applying the Arrhenius equation integral on the computed time-dependent spatial distribution of temperature in the brain tissue during ESM stimulation and during the cooldown period. The results showed increases in temperature in the proximity around ECoG electrode discs in a safe range without destructive effects. As opposed to open craniotomy, subdural space is not cooled by the air; hence a higher - but still safe - induced temperature was observed. The presented simulation agrees with the previously published histopathological examination of the stimulated brain tissue, and confirms the safety of the novel ESM technique when applied using ECoG strip electrodes.