학술논문
Evaluation of a new cortical strip electrode for intraoperative somatosensory monitoring during perirolandic brain surgery.
Document Type
Academic Journal
Author
Sarnthein J; Department of Neurosurgery, University Hospital, University of Zurich, Switzerland. Electronic address: johannes.sarnthein@usz.ch.; Seidel K; Department of Neurosurgery, Inselspital, Bern University Hospital, Bern, Switzerland.; Neidert MC; Department of Neurosurgery, University Hospital, University of Zurich, Switzerland.; Raabe A; Department of Neurosurgery, Inselspital, Bern University Hospital, Bern, Switzerland.; Sala F; Department of Neurosurgery, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy.; Tonn JC; Department of Neurosurgery, University Hospital, LMU München, Munich, Germany.; Thon N; Department of Neurosurgery, University Hospital, LMU München, Munich, Germany.; Szelenyi A; Department of Neurosurgery, University Hospital, LMU München, Munich, Germany.
Source
Publisher: Elsevier Country of Publication: Netherlands NLM ID: 100883319 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1872-8952 (Electronic) Linking ISSN: 13882457 NLM ISO Abbreviation: Clin Neurophysiol Subsets: MEDLINE
Subject
Language
English
Abstract
Objective: During neurosurgical procedures, strip electrodes should have low impedance and sufficient adherence on the brain surface. We evaluated the signal quality, safety, and performance of a novel strip electrode (WISE Cortical Strip, WCS®), with conductive electrode contacts created with platinum nanoparticles embedded in a polymer base.
Methods: In a multicenter interventional, non-inferiority study, we compared WCS to a conventional strip electrode (Ad-Tech). We recorded impedance and somatosensory evoked potentials (SEP) and determined the signal-to-noise ratio (SNR). We performed direct stimulation of the motor cortex. An external clinical event committee rated safety and adverse events and users rated usability.
Results: During 32 brain surgeries in the paracentral region, WCS was rated safe and effective in signal transmission. Two seizure events were classified as probably related to the stimulation with WCS. The users rated WCS adhesion to the brain as satisfactory but reported difficulties sliding the WCS under the dura. The median (IQR) impedance of WCS was lower than for Ad-Tech: 2.7 (2.3-3.7) vs 5.30 (4.3-6.6) kΩ (p < 0.005). The SNR of SEP was non-inferior for WCS compared to Ad-Tech.
Conclusions: The impedance of WCS was lower than Ad-Tech without safety limitations. In small craniotomies not exposing the motor cortex its use may be limited.
Significance: Low impedance electrodes facilitate recordings with high SNR.
Competing Interests: Conflict of interest None of the authors have potential conflicts of interest to be disclosed. All authors declare that they participated in the study without receiving personal compensation. AS, KS, JS are members of the IOM board of inomed Medizintechnik GmbH and have received speaker honoraria. MCN has reviewed documentation for WISE and his institution has received research funds from WISE Srl.
(Copyright © 2022 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.)
Methods: In a multicenter interventional, non-inferiority study, we compared WCS to a conventional strip electrode (Ad-Tech). We recorded impedance and somatosensory evoked potentials (SEP) and determined the signal-to-noise ratio (SNR). We performed direct stimulation of the motor cortex. An external clinical event committee rated safety and adverse events and users rated usability.
Results: During 32 brain surgeries in the paracentral region, WCS was rated safe and effective in signal transmission. Two seizure events were classified as probably related to the stimulation with WCS. The users rated WCS adhesion to the brain as satisfactory but reported difficulties sliding the WCS under the dura. The median (IQR) impedance of WCS was lower than for Ad-Tech: 2.7 (2.3-3.7) vs 5.30 (4.3-6.6) kΩ (p < 0.005). The SNR of SEP was non-inferior for WCS compared to Ad-Tech.
Conclusions: The impedance of WCS was lower than Ad-Tech without safety limitations. In small craniotomies not exposing the motor cortex its use may be limited.
Significance: Low impedance electrodes facilitate recordings with high SNR.
Competing Interests: Conflict of interest None of the authors have potential conflicts of interest to be disclosed. All authors declare that they participated in the study without receiving personal compensation. AS, KS, JS are members of the IOM board of inomed Medizintechnik GmbH and have received speaker honoraria. MCN has reviewed documentation for WISE and his institution has received research funds from WISE Srl.
(Copyright © 2022 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.)