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Recording Human Electrocorticographic ECoG Signals for Neuroscientific Research and Real-time Functional Cortical Mapping

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Implementing intraoperative high-density electrocorticography during epilepsy surgery.

Eline V Schaft¹, Dongqing Sun¹, Sem Hoogteijling^1,2

¹Department of Neurology and Neurosurgery, University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Part of ERN EpiCARE, Utrecht, The Netherlands.

|February 11, 2025

Summary

This summary is machine-generated.

High-density intraoperative electrocorticography (HD-ioECoG) offers greater detail in epilepsy surgery by capturing localized epileptic spikes and fast ripples (FRs). This improved detection can refine surgical strategies and potentially enhance patient outcomes.

Keywords:

focal seizures high‐frequency oscillations intraoperative tailoring subdural EEG

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Performing Behavioral Tasks in Subjects with Intracranial Electrodes

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Published on: October 2, 2014

Area of Science:

Neurosurgery
Epileptology
Neurophysiology

Background:

Standard epilepsy surgery uses low-density (LD) electrode grids with limited cortical coverage.
High-density (HD) grids show promise in research but require clinical evaluation for epilepsy surgery.

Purpose of the Study:

To assess the clinical utility of HD grids in intraoperative electrocorticography (ioECoG) for epilepsy surgery.
To determine if HD-ioECoG alters surgical plans by detecting localized epileptic activity and improving spike-onset localization.

Main Methods:

Patients undergoing HD-ioECoG (64 electrodes, 5mm spacing) for epilepsy surgery were analyzed.
Interictal spikes and high-frequency oscillations (HFOs), including ripples and fast ripples (FRs), were visually marked.
Spike-onset localization was assessed using Granger's causality.

Main Results:

HD-ioECoG potentially altered surgical plans in 6 out of 20 patients.
More FRs were detected in resected areas, correlating with seizure freedom (p < .001).
A significant percentage of focal events (spikes, ripples, FRs) occurred on one or two channels, potentially missed by LD grids.

Conclusions:

HD-ioECoG is clinically feasible for guiding epilepsy surgery.
HD-ioECoG provides enhanced detail for identifying focal epileptic events, particularly FRs.
Improved detection of focal events and spike onsets with HD-ioECoG may refine surgical decision-making.