Surgical Robot-Enhanced Implantation of Intracranial Depth Electrodes for Single Neuron Recording Studies in Patients with Medically Refractory Epilepsy: A Technical Note

OBJECTIVE

Single neuron or unit recording enables researchers to measure the electrophysiologic responses of single neurons using a microelectrode system. This approach is widely used in cognitive science and has become more widespread in humans with the use of hybrid (micro-within-macrowire) depth electrodes that enable the implantation of microwires into the brain parenchyma.

METHODS

The authors describe their surgical technique in a total of 7 patients with intractable epilepsy who underwent robot-enhanced stereoencephalography in which both standard (nonhybrid) and hybrid depth electrodes were used for invasive chronic monitoring.

RESULTS

The technique and accuracy of the procedure were evaluated with a total of 84 depth electrodes (46 hybrid, 38 standard) in 7 patients. No major complications, such as intracranial hemorrhage, infection or cerebrospinal fluid leakage, occurred regardless of the type of electrode used.

CONCLUSIONS

The addition of hybrid depth electrodes for the purpose of in vivo single neuron recording in robot-enhanced stereoencephalography procedures is safe and does not impact the accuracy of targeting or patient safety.

Reducing the Effect of Spurious Phase Variations in Neural Oscillatory Signals

The phase-reset model of oscillatory EEG activity has received a lot of attention in the last decades for decoding different cognitive processes. Based on this model, the ERPs are assumed to be generated as a result of phase reorganization in ongoing EEG. Alignment of the phase of neuronal activities can be observed within or between different assemblies of neurons across the brain. Phase synchronization has been used to explore and understand perception, attentional binding and considering it in the domain of neuronal correlates of consciousness. The importance of the topic and its vast exploration in different domains of the neuroscience presses the need for appropriate tools and methods for measuring the level of phase synchronization of neuronal activities. Measuring the level of instantaneous phase (IP) synchronization has been used extensively in numerous studies of ERPs as well as oscillatory activity for a better understanding of the underlying cognitive binding with regard to different set of stimulations such as auditory and visual. However, the reliability of results can be challenged as a result of noise artifact in IP. Phase distortion due to environmental noise artifacts as well as different pre-processing steps on signals can lead to generation of artificial phase jumps. One of such effects presented recently is the effect of low envelope on the IP of signal. It has been shown that as the instantaneous envelope of the analytic signal approaches zero, the variations in the phase increase, effectively leading to abrupt transitions in the phase. These abrupt transitions can distort the phase synchronization results as they are not related to any neurophysiological effect. These transitions are called spurious phase variation. In this study, we present a model to remove generated artificial phase variations due to the effect of low envelope. The proposed method is based on a simplified form of a Kalman smoother, that is able to model the IP behavior in narrow-bandpassed oscillatory signals. In this work we first explain the details of the proposed Kalman smoother for modeling the dynamics of the phase variations in narrow-bandpassed signals and then evaluate it on a set of synthetic signals. Finally, we apply the model on ongoing-EEG signals to assess the removal of spurious phase variations.

Recent Progress on Microelectrodes in Neural Interfaces

Brain‒machine interface (BMI) is a promising technology that looks set to contribute to the development of artificial limbs and new input devices by integrating various recent technological advances, including neural electrodes, wireless communication, signal analysis, and robot control. Neural electrodes are a key technological component of BMI, as they can record the rapid and numerous signals emitted by neurons. To receive stable, consistent, and accurate signals, electrodes are designed in accordance with various templates using diverse materials. With the development of microelectromechanical systems (MEMS) technology, electrodes have become more integrated, and their performance has gradually evolved through surface modification and advances in biotechnology. In this paper, we review the development of the extracellular/intracellular type of in vitro microelectrode array (MEA) to investigate neural interface technology and the penetrating/surface (non-penetrating) type of in vivo electrodes. We briefly examine the history and study the recently developed shapes and various uses of the electrode. Also, electrode materials and surface modification techniques are reviewed to measure high-quality neural signals that can be used in BMI.

Neural Interfaces for Intracortical Recording: Requirements, Fabrication Methods, and Characteristics

Implantable neural interfaces for central nervous system research have been designed with wire, polymer, or micromachining technologies over the past 70 years. Research on biocompatible materials, ideal probe shapes, and insertion methods has resulted in building more and more capable neural interfaces. Although the trend is promising, the long-term reliability of such devices has not yet met the required criteria for chronic human application. The performance of neural interfaces in chronic settings often degrades due to foreign body response to the implant that is initiated by the surgical procedure, and related to the probe structure, and material properties used in fabricating the neural interface. In this review, we identify the key requirements for neural interfaces for intracortical recording, describe the three different types of probes-microwire, micromachined, and polymer-based probes; their materials, fabrication methods, and discuss their characteristics and related challenges.

A Multimodal, SU-8 - Platinum - Polyimide Microelectrode Array for Chronic In Vivo Neurophysiology

Utilization of polymers as insulator and bulk materials of microelectrode arrays (MEAs) makes the realization of flexible, biocompatible sensors possible, which are suitable for various neurophysiological experiments such as in vivo detection of local field potential changes on the surface of the neocortex or unit activities within the brain tissue. In this paper the microfabrication of a novel, all-flexible, polymer-based MEA is presented. The device consists of a three dimensional sensor configuration with an implantable depth electrode array and brain surface electrodes, allowing the recording of electrocorticographic (ECoG) signals with laminar ones, simultaneously. In vivo recordings were performed in anesthetized rat brain to test the functionality of the device under both acute and chronic conditions. The ECoG electrodes recorded slow-wave thalamocortical oscillations, while the implanted component provided high quality depth recordings. The implants remained viable for detecting action potentials of individual neurons for at least 15 weeks.

Epilepsy surgery: current status and ongoing challenges

This article reviews the current status of surgical treatment of epilepsy and introduces the ongoing challenges. Seizure outcome of resective surgery for focal seizures associated with focal lesions is satisfactory. Particularly for mesial temporal lobe epilepsy, surgical treatment should be considered from the earlier stage of the disease. Meanwhile, surgical outcome in nonlesional extratemporal lobe epilepsy is still to be improved using various approaches. Disconnective surgeries reduce surgical complications of extensive resections while achieving equivalent or better seizure outcomes. Multiple subpial transection is still being modified expecting a better outcome by transection to the vertical cortices along the sulci- and multi-directional transection from a single entry point. Hippocampal transection is expected to preserve memory function while interrupting the abnormal epileptic synchronization. Proper selection or combination of subdural and depth electrodes and a wide-band analysis of electroencephalography may improve the accurate localization of epileptogenic region. Patients for whom curative resective surgery is not indicated because of generalized or bilateral multiple nature of their epilepsies, neuromodulation therapies are options of treatment which palliate their seizures.