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

World Neurosurg. 2021 Jan:145:210-219. doi: 10.1016/j.wneu.2020.09.100. Epub 2020 Sep 25.

Abstract

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.

Keywords: Robot-enhanced neurosurgery; Single neuron recording; Stereoelectroencephalography.

MeSH terms

  • Adult
  • Brain / diagnostic imaging
  • Brain / surgery*
  • Device Removal
  • Drug Resistant Epilepsy / diagnostic imaging
  • Drug Resistant Epilepsy / surgery*
  • Electrodes, Implanted*
  • Electroencephalography / instrumentation
  • Female
  • Humans
  • Male
  • Microelectrodes
  • Middle Aged
  • Neurons*
  • Neurosurgical Procedures
  • Patient Selection
  • Preoperative Care
  • Prosthesis Implantation / methods*
  • Robotic Surgical Procedures / methods*
  • Treatment Outcome
  • Young Adult