Initial surgical experience with a dense cortical microarray in epileptic patients undergoing craniotomy for subdural electrode implantation.
Initial surgical experience with a dense cortical microarray in epileptic patients undergoing craniotomy for subdural electrode implantation.
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DOI：
10.1227/01.neu.0000337575.63861.10
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发表时间：
2009-03
期刊：
影响因子：
4.8
通讯作者：
Goodman RR
中科院分区：
文献类型：
--
作者：
Waziri A;Schevon CA;Cappell J;Emerson RG;McKhann GM 2nd;Goodman RR
对皮层生理学的详细研究需要能够在亚毫米尺度上记录脑电活动。标准颅内电极导致大量神经元产生的电位显著平均。相比之下，微电极阵列（MEA）允许记录局部场电位（LFP）和单个单元活动。我们描述了我们在一系列接受硬膜下电极植入以监测癫痫的患者中使用NeuroPort™ MEA的初步手术经验。7名患者在癫痫的标准硬膜下电极监测期间植入NeuroPort™阵列并接受半慢记录。根据公司规范将电极放置在假定的非功能性癫痫皮质中。监测期结束后，在硬膜下电极固定和致痫组织切除过程中取出MEA。在所有存在轻微手术困难的患者中均成功植入MEA。从所有植入个体中获得了稳健和持久的LFP和单单位记录。植入时间范围为3-28天;植入组织的组织学分析显示无显著组织损伤或炎症反应。没有与电极植入或长时间监测相关的神经系统并发症或感染。两名患者在头皮出口部位出现了切除后伤口愈合问题，其中一名患者需要手术伤口翻修。我们的经验表明，使用NeuroPort™微阵列可以安全有效地实现半慢性微EEG记录。虽然没有遇到严重的组织损伤、感染或CSF泄漏，但连接基座的大轮廓导致几名患者的伤口闭合和愈合不佳。我们预测，这个问题将很容易在第二代设备中得到解决。
Detailed investigations of cortical physiology require the ability to record brain electrical activity at a submillimeter scale. Standard intracranial electrodes result in significant averaging of potentials generated by large numbers of neurons. In contrast, microelectrode arrays (MEA) allow for recording of local field potentials (LFPs) and single unit activity. We describe our initial surgical experience with the NeuroPort™ MEA in a series of patients undergoing subdural electrode implantation for epilepsy monitoring. Seven patients were implanted with and underwent semichronic recording from the NeuroPort™ array during standard subdural electrode monitoring for epilepsy. The electrode was placed per company specifications in putative non-eloquent epileptogenic cortex. Following the monitoring period, MEAs were removed during explantation of subdural electrodes and resection of epileptogenic tissue. Successful implantation of the MEA was achieved in all patients with minor operative difficulties. Robust and durable LFPs and single-unit recordings were obtained from all implanted individuals. Implantation times ranged from 3–28 days; histological analysis of implanted tissue demonstrated no significant tissue injury or inflammatory response. There were no neurological complications or infections associated with electrode implantation or prolonged monitoring. Two patients developed post-resection issues with wound healing at the site of scalp egress, one requiring operative wound revision. Our experience demonstrates that semi-chronic micro-EEG recording can be safely and effectively achieved using the NeuroPort™ microarray. Although significant tissue injury, infection or CSF leak were not encountered, the large profile of the connection pedestal resulted in suboptimal wound closure and healing in several patients. We predict that this problem will be easily addressed in second-generation devices.