3D visualization of subdural electrode shift as measured at craniotomy reopening

Department of Biophysics, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
Epilepsy research (Impact Factor: 2.02). 02/2011; 94(1-2):102-9. DOI: 10.1016/j.eplepsyres.2011.01.011
Source: PubMed


Subdural electrodes are implanted for recording intracranial EEG (iEEG) in cases of medically refractory epilepsy as a means to locate cortical regions of seizure onset amenable to surgical resection. Without the aid of imaging-derived 3D electrode models for surgical planning, surgeons have relied on electrodes remaining stationary from the time between placement and follow-up resection. This study quantifies electrode shift with respect to the cortical surface occurring between electrode placement and subsequent reopening.
CT and structural MRI data were gathered following electrode placement on 10 patients undergoing surgical epilepsy treatment. MRI data were used to create patient specific post-grid 3D reconstructions of cortex, while CT data were co-registered to the MRI and thresholded to reveal electrodes only. At the time of resective surgery, the craniotomy was reopened and electrode positions were determined using intraoperative navigational equipment. Changes in position were then calculated between CT coordinates and intraoperative electrode coordinates.
Five out of ten patients showed statistically significant overall magnitude differences in electrode positions (mean: 7.2mm), while 4 exhibited significant decompression based shift (mean: 4.7mm), and 3 showed significant shear displacement along the surface of the brain (mean: 7.1mm).
Shift in electrode position with respect to the cortical surface has never been precisely measured. We show that in 50% of our cases statistically significant shift occurred. These observations demonstrate the potential utility of complimenting electrode position measures at the reopening of the craniotomy with 3D electrode and brain surface models derived from post-implantation CT and MR imaging for better definition of surgical boundaries.

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    • "The desired registration will be a global cost minimum with respect to modality overlap. With all these registration methods, a reference intra-operative photo of the electrodes in situ can be useful to correct any residual registration error according to the anatomic shapes of the blood vessels and sulci (LaViolette and others 2011). "
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    ABSTRACT: Intracranial electro-encephalography (icEEG) provides a unique opportunity to record directly from the human brain and is clinically important for planning epilepsy surgery. However, traditional visual analysis of icEEG is often challenging. The typical simultaneous display of multiple electrode channels can prevent an in-depth understanding of the spatial-time course of brain activity. In recent decades, advances in the field of neuroimaging have provided powerful new tools for the analysis and display of signals in the brain. These methods can now be applied to icEEG to map electrical signal information onto a three-dimensional rendering of a patient's cortex and graphically observe the changes in voltage over time. This approach provides rapid visualization of seizures and normal activity propagating over the brain surface and can also illustrate subtle changes that might be missed by traditional icEEG analysis. In addition, the direct mapping of signal information onto accurate anatomical structures can assist in the precise targeting of sites for epilepsy surgery and help correlate electrical activity with behavior. Bringing icEEG data into a standardized anatomical space will also enable neuroimaging methods of statistical analysis to be applied. As new technologies lead to a dramatic increase in the rate of data acquisition, these novel visualization and analysis techniques will play an important role in processing the valuable information obtained through icEEG.
    The Neuroscientist 05/2012; 19(3). DOI:10.1177/1073858412447876 · 6.84 Impact Factor
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    • "In all patients, intraoperative pictures were taken with a digital camera before dural closure as well as after re-opening, to confirm the spatial accuracy of electrode display on the 3D brain surface reconstructed from MRI (Nagasawa et al., 2011; Wu et al., 2011). Nonetheless, a minor spatial error in coregistration of MRI and subdural electrodes (LaViolette et al., 2011) could not be ruled out in non-visualized occipital regions in some patients in the present study. "
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    ABSTRACT: Neuronal adaptation is defined as a reduced neural response to a repeated stimulus and can be demonstrated by reduced augmentation of event-related gamma activity. Several studies reported that variance in the degree of gamma augmentation could be explained by pre-stimulus low-frequency oscillations. Here, we measured the spatio-temporal characteristics of visually-driven amplitude modulations in human primary visual cortex using intracranial electrocorticography. We determined if inter-stimulus intervals or pre-stimulus oscillations independently predicted local neuronal adaptation measured with amplitude changes of high-gamma activity at 80-150 Hz. Participants were given repetitive photic stimuli with a flash duration of 20 μs in each block; the inter-stimulus interval was set constant within each block but different (0.2, 0.5, 1.0 or 2.0s) across blocks. Stimuli elicited augmentation of high-gamma activity in the occipital cortex at about 30 to 90 ms, and high-gamma augmentation was most prominent in the medial occipital region. High-gamma augmentation was subsequently followed by lingering beta augmentation at 20-30 Hz and high-gamma attenuation. Neuronal adaptation was demonstrated as a gradual reduction of high-gamma augmentation over trials. Multivariate analysis demonstrated that a larger number of prior stimuli, shorter inter-stimulus interval, and pre-stimulus high-gamma attenuation independently predicted a reduced high-gamma augmentation in a given trial, while pre-stimulus beta amplitude or delta phase had no significant predictive value. Association between pre-stimulus high-gamma attenuation and a reduced neural response suggests that high-gamma attenuation represents a refractory period. The local effects of pre-stimulus beta augmentation and delta phase on neuronal adaptation may be modest in primary visual cortex.
    NeuroImage 09/2011; 59(2):1639-46. DOI:10.1016/j.neuroimage.2011.09.014 · 6.36 Impact Factor
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    ABSTRACT: Not Available
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