Detection of after-discharges during intraoperative functional brain mapping in awake brain tumor surgery using a novel high-density circular grid

William O. Tatum, Jake H. McKay, Karim ReFaey, Anteneh M. Feyissa, Dan Ryan, Anthony Ritaccio, Erik Middlebrooks, Kirsten Yelvington, Grayson Roth, Emily Acton, Sanjeet Grewal, Kaisorn Chaichana, Alfredo Quinones-Hinojosa

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)828-835
Number of pages8
JournalClinical Neurophysiology
Volume131
Issue number4
DOIs
StatePublished - Apr 2020

Keywords

  • After-discharge
  • Electrical stimulation
  • Electrocorticography
  • High-density
  • Seizure brain mapping

ASJC Scopus subject areas

  • Sensory Systems
  • Neurology
  • Clinical Neurology
  • Physiology (medical)

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