William O Tatum1, Jake H McKay2, Karim ReFaey3, Anteneh M Feyissa2, Dan Ryan2, Anthony Ritaccio2, Erik Middlebrooks4, Kirsten Yelvington5, Grayson Roth6, Emily Acton7, Sanjeet Grewal3, Kaisorn Chaichana3, Alfredo Quinones-Hinojosa8. 1. Department of Neurology, Mayo Clinic, Jacksonville, FL, USA. Electronic address: Tatum.William@mayo.edu. 2. Department of Neurology, Mayo Clinic, Jacksonville, FL, USA. 3. Department of Neurosurgery, Mayo Clinic, Jacksonville, FL, USA. 4. Department of Radiology, Mayo Clinic, Jacksonville, FL, USA. 5. Department of Clinical Neurophysiology, Mayo Clinic, Jacksonville, FL, USA. 6. Haverford College, Philadelphia, PA, USA. 7. University of Pennsylvania, Philadelphia, PA, USA. 8. Department of Neurosurgery, Mayo Clinic, Jacksonville, FL, USA. Electronic address: Quinones-Hinojosa.Alfredo@mayo.edu.
Abstract
OBJECTIVE: To evaluate intraoperative use of a novel high-density circular grid in detecting after-discharges (AD) on electrocorticography (ECoG) during functional brain mapping (FBM). METHODS: FBM during glioma surgery (10/2016 to 5/2019) recorded ADs using a 22-channel circular grid compared to conventional strip electrodes. ADs were analyzed for detection, duration, amplitude, morphology, histology, direction, and clinical signs. RESULTS: Thirty-two patients (mean age 54.2 years; r = 30-75) with glioma (WHO grade II-IV; 20 grade IV) had surgery. ADs during FBM were more likely in patients with wild-type as opposed to IDH-1 mutants (p < 0.0001) using more contacts compared with linear strip electrodes (p = 0.0001). More sensors tended to be involved in ADs detected by the circular grid vs strips (6.61 vs 3.43; p = 0.16) at lower stimulus intensity (3.14 mA vs 4.13 mA; p = 0.09). No difference in the number of cortical stimulations before resection was present (38.9 mA vs 47.9 mA; p = 0.26). ADs longer than 10 seconds were 32.5 seconds (circular grid) vs 58.4 (strips) (p = 0.12). CONCLUSIONS: High-density circular grids detect ADs in 360 degrees during FBM for glioma resection. Provocation of ADs was more likely in patients with wild-type than IDH-1 mutation. SIGNIFICANCE: Circular grids offer high-resolution ECoG during intraoperative FBM for detection of ADs.
OBJECTIVE: To evaluate intraoperative use of a novel high-density circular grid in detecting after-discharges (AD) on electrocorticography (ECoG) during functional brain mapping (FBM). METHODS: FBM during glioma surgery (10/2016 to 5/2019) recorded ADs using a 22-channel circular grid compared to conventional strip electrodes. ADs were analyzed for detection, duration, amplitude, morphology, histology, direction, and clinical signs. RESULTS: Thirty-two patients (mean age 54.2 years; r = 30-75) with glioma (WHO grade II-IV; 20 grade IV) had surgery. ADs during FBM were more likely in patients with wild-type as opposed to IDH-1 mutants (p < 0.0001) using more contacts compared with linear strip electrodes (p = 0.0001). More sensors tended to be involved in ADs detected by the circular grid vs strips (6.61 vs 3.43; p = 0.16) at lower stimulus intensity (3.14 mA vs 4.13 mA; p = 0.09). No difference in the number of cortical stimulations before resection was present (38.9 mA vs 47.9 mA; p = 0.26). ADs longer than 10 seconds were 32.5 seconds (circular grid) vs 58.4 (strips) (p = 0.12). CONCLUSIONS: High-density circular grids detect ADs in 360 degrees during FBM for glioma resection. Provocation of ADs was more likely in patients with wild-type than IDH-1 mutation. SIGNIFICANCE: Circular grids offer high-resolution ECoG during intraoperative FBM for detection of ADs.
Authors: Karim ReFaey; Shashwat Tripathi; Adip G Bhargav; Sanjeet S Grewal; Erik H Middlebrooks; David S Sabsevitz; Mark Jentoft; Peter Brunner; Adela Wu; William O Tatum; Anthony Ritaccio; Kaisorn L Chaichana; Alfredo Quinones-Hinojosa Journal: J Neurooncol Date: 2020-06-10 Impact factor: 4.130
Authors: Ricardo A Domingo; Tito Vivas-Buitrago; Gaetano De Biase; Erik H Middlebrooks; Perry S Bechtle; David S Sabsevitz; Alfredo Quiñones-Hinojosa; William O Tatum Journal: Oper Neurosurg (Hagerstown) Date: 2021-07-15 Impact factor: 2.703