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Recording Human Electrocorticographic ECoG Signals for Neuroscientific Research and Real-time Functional Cortical Mapping
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Supplementing Extraoperative Electrocorticography With Real-Time Intraoperative Recordings Using the Same Chronically
Nebras M Warsi1,2, Karl Narvacan1,2, Elizabeth Donner3
1Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
Operative Neurosurgery (Hagerstown, Md.)
|February 8, 2021
Summary
This study presents a novel technique for real-time intraoperative electrocorticography (iECoG) during epilepsy surgery. The method uses existing electrodes to guide resection, improving surgical decision-making and potentially reducing limitations of traditional iECoG.
Area of Science:
- Neurosurgery
- Epileptology
- Medical Devices
Background:
- Intraoperative electrocorticography (iECoG) use in epilepsy surgery is inconsistent.
- Current iECoG methods face challenges including variable recordings, increased costs, and unclear surgical benefits.
Purpose of the Study:
- To present a straightforward technique for real-time iECoG during epilepsy surgery.
- This method utilizes existing chronically implanted electrodes to overcome limitations of conventional iECoG.
Main Methods:
- Described is a technical procedure for 7 pediatric epilepsy patients undergoing 2-stage resective surgery.
- Subdural grids, strips, and depth electrodes were used for both extraoperative and real-time intraoperative mapping.
- Resection planning was guided by extraoperative ictal and interictal recordings.
Main Results:
- Real-time iECoG guided resection modifications in 2 of 7 patients.
- One resection was extended due to a distant seizure, another restricted due to reduced epileptiform activity.
- No adverse events or infections were reported.
Conclusions:
- A simple technique for real-time iECoG using chronically implanted electrodes in 2-stage epilepsy surgery is presented.
- This approach offers fewer limitations compared to traditional methods and can influence intraoperative decisions.
