• Clin Neurophysiol · Apr 2020

    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, and Alfredo Quinones-Hinojosa.
    • Department of Neurology, Mayo Clinic, Jacksonville, FL, USA. Electronic address: Tatum.William@mayo.edu.
    • Clin Neurophysiol. 2020 Apr 1; 131 (4): 828-835.

    ObjectiveTo evaluate intraoperative use of a novel high-density circular grid in detecting after-discharges (AD) on electrocorticography (ECoG) during functional brain mapping (FBM).MethodsFBM 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.ResultsThirty-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).ConclusionsHigh-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.SignificanceCircular grids offer high-resolution ECoG during intraoperative FBM for detection of ADs.Copyright © 2020 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

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