Initial surgical experience with a dense cortical microarray in epileptic patients undergoing craniotomy for subdural electrode implantation.
Academic Article
Overview
abstract
OBJECTIVE: 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 allow for recording of local field potentials and single-unit activity. We describe our initial surgical experience with the NeuroPort microelectrode array (Cyberkinetics Neurotechnology Systems, Inc., Salt Lake City, UT) in a series of patients undergoing subdural electrode implantation for epilepsy monitoring. METHODS: Seven patients were implanted with and underwent semichronic recording from the NeuroPort array during standard subdural electrode monitoring for epilepsy. The electrode was placed according to company specifications in putative noneloquent epileptogenic cortex. After the monitoring period, microelectrode arrays were removed during explantation of subdural electrodes and resection of epileptogenic tissue. RESULTS: Successful implantation of the microelectrode array was achieved in all patients, with minor operative difficulties. Robust and durable local field potentials and single-unit recordings were obtained from all implanted individuals. Implantation times ranged from 3 to 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 postresection issues with wound healing at the site of scalp egress, with 1 requiring operative wound revision. CONCLUSION: Our experience demonstrates that semichronic microelectroencephalographic recording can be safely and effectively achieved using the NeuroPort microarray. Although significant tissue injury, infection, or cerebrospinal fluid leak was 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.
