脳腫瘍の機能的脳マッピング中の術中脳波検査デバイスを使用した人工的信号検出

To compare the signal detection performance of a circular grid versus a strip electrode during intraoperative electrocorticography (iECoG) for Functional Brain Mapping (FBM).

We performed a single center retrospective evaluation of signal detection by recording intraoperative ECoG comparing two intraoperative recording devices and techniques during awake craniotomy for FBM. A circular grid and linear strip evaluated stimulation artifact, afterdischarges (ADs), and epileptiform activity.

142 patients underwent awake craniotomy, and 26 (18.3 %) had reoperations with repeat iECoG performed during their subsequent procedure. A total of 71 patients underwent iECoG using circular grids and 71 with linear strip electrodes. Max and min Signal amplitudes were higher with the circular grid (p < 0.01). The minimum (2.3 vs. 2.8 mA) and maximum (4.9 vs. 6.3 mA) currents required to evoke visible stimulation artifact were lower with the circular grid (p < 0.01), suggesting increased sensitivity to stimulation-related signals. Physiological signals represented by ADs were detected in 59.2 % of circular-grid patients vs 40.8 % of strip-electrode patients (Fisher's exact p = 0.044). When adjusting for stimulation trials in a Negative Binomial model with an offset, AD rates per stimulation were 2.5 × higher with circular grids (rate ratio 2.51; 95 % CI 1.61-3.91; p < 0.0001). Total stimulation counts were 2,786 (circular) and 2,209 (strip). Notably, the circular grid also involved more electrodes (5.06 vs. 0.95,p < 0.001).

High-density circular grids enhance intraoperative detection of artifacts and ADs with lower stimulus currents.

The high-density circular grid offered more interpretable contacts and higher sensitivity.