Evaluation of a new cortical strip electrode for intraoperative somatosensory monitoring during perirolandic brain surgery. 2022

Johannes Sarnthein, and Kathleen Seidel, and Marian Christoph Neidert, and Andreas Raabe, and Francesco Sala, and Joerg Christian Tonn, and Niklas Thon, and Andrea Szelenyi
Department of Neurosurgery, University Hospital, University of Zurich, Switzerland. Electronic address: johannes.sarnthein@usz.ch.

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. 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. 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. 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. Low impedance electrodes facilitate recordings with high SNR.

UI MeSH Term Description Entries
D010984 Platinum A heavy, soft, whitish metal, resembling tin, with atomic number 78, atomic weight 195.084, symbol Pt. It is used in manufacturing equipment for laboratory and industrial use. It occurs as a black powder (platinum black) and as a spongy substance (spongy platinum) and may have been known in Pliny's time as "alutiae". Platinum Black
D011108 Polymers Compounds formed by the joining of smaller, usually repeating, units linked by covalent bonds. These compounds often form large macromolecules (e.g., BIOPOLYMERS; PLASTICS). Polymer
D001921 Brain The part of CENTRAL NERVOUS SYSTEM that is contained within the skull (CRANIUM). Arising from the NEURAL TUBE, the embryonic brain is comprised of three major parts including PROSENCEPHALON (the forebrain); MESENCEPHALON (the midbrain); and RHOMBENCEPHALON (the hindbrain). The developed brain consists of CEREBRUM; CEREBELLUM; and other structures in the BRAIN STEM. Encephalon
D004558 Electric Stimulation Use of electric potential or currents to elicit biological responses. Stimulation, Electric,Electrical Stimulation,Electric Stimulations,Electrical Stimulations,Stimulation, Electrical,Stimulations, Electric,Stimulations, Electrical
D004566 Electrodes Electric conductors through which electric currents enter or leave a medium, whether it be an electrolytic solution, solid, molten mass, gas, or vacuum. Anode,Anode Materials,Cathode,Cathode Materials,Anode Material,Anodes,Cathode Material,Cathodes,Electrode,Material, Anode,Material, Cathode
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D053768 Metal Nanoparticles Nanoparticles produced from metals whose uses include biosensors, optics, and catalysts. In biomedical applications the particles frequently involve the noble metals, especially gold and silver. Metal Nanocrystals,Metallic Nanocrystals,Metallic Nanoparticles,Metal Nanocrystal,Metal Nanoparticle,Metallic Nanocrystal,Metallic Nanoparticle,Nanocrystal, Metal,Nanocrystal, Metallic,Nanocrystals, Metal,Nanocrystals, Metallic,Nanoparticle, Metal,Nanoparticle, Metallic,Nanoparticles, Metal,Nanoparticles, Metallic

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