A Personalized Stereotactic Fixture for Implantation of Depth Electrodes in Stereoelectroencephalography

Bălănescu, Bogdan; Franklin, Ronald D.; Ciurea, Jean; Mı̂ndruță, Ioana; Raşină, Alin; Bobulescu, Razvan C; Donos, Cristian; Barborică, Andrei

doi:10.1159/000360226

Cited by 41 publications

(20 citation statements)

References 14 publications

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“…Of the studies reporting the number of electrodes inserted, an average of 10 electrodes were placed per patient (range 2–22) . Study size was highly variable, ranging from 4 to 500 patients, with an average of 87 patients per study . The patient ages were also widely distributed, with ages between 1 and 69; the average age was 24 .…”

Section: Resultsmentioning

confidence: 99%

“…11,17 Study size was highly variable, ranging from 4 to 500 patients, with an average of 87 patients per study. 18,19 The patient ages were also widely distributed, with ages between 1 and 69; the average age was 24. 20,21 Patient monitoring with electrodes in place averaged 11 days, with some patients monitored for only 2 days, whereas others had electrodes in place for up to 33 days.…”

Section: Study Demographicmentioning

confidence: 99%

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Is SEEG safe? A systematic review and meta‐analysis of stereo‐electroencephalography–related complications

et al. 2016

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SUMMARYObjective: Stereo-electroencephalography (SEEG) is a procedure performed for patients with intractable epilepsy in order to anatomically define the epileptogenic zone (EZ) and the possible related functional cortical areas. By avoiding the need for large craniotomies and due to its intrinsic precision placement features, SEEG may be associated with fewer complications. Nevertheless, intracerebral electrodes have gained a reputation of excessive invasiveness, with a "relatively high morbidity" associated with their placement. A systematic literature review and meta-analysis of SEEG complications has not been previously performed. The goal of this study is to quantitatively review the incidence of various surgical complications associated with SEEG electrode implantation in the literature and to provide a summary estimate. This will allow physicians to accurately counsel their patients about the potential complications related to this method of extraoperative invasive monitoring. Methods: The systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We conducted MEDLINE, Scopus, and Web of Science database searches with the search algorithm. We analyzed complication rates using a fixed-effects model with inverse variance weighting. Calculations for the meta-analysis and construction of forest plots were completed using an established spreadsheet. The principal summary measures were the effect summary value and 95% confidence intervals (CIs). Results: The initial 1,901 retrieved citations were reviewed. After removing 787 duplicates, the titles and abstracts of 1,114 publications were screened. At this stage, studies that did not mention the absence or presence of complications following SEEG or that did not fulfill the inclusion criteria in any manner were excluded. After excluding 1,057 citations, the full text was assessed in the resulting 57 articles for eligibility criteria. The most common complications were hemorrhagic (pooled prevalence 1.0%, 95% confidence interval [CI] 0.6-1.4%) or infectious (pooled prevalence 0.8%, 95% CI 0.3-1.2%). Five mortalities were identified (pooled prevalence 0.3%, 95% CI À0.1-0.6%). Overall, our analysis identified 121 surgical complications related to SEEG insertion and monitoring (pooled prevalence 1.3%, 95% CI 0.9-1.7%). Significance: This review represents a comprehensive estimation of the actual incidence of complications related to SEEG. We report a rate substantially lower than the complication rates reported for other methods of extraoperative invasive monitoring. These data should alleviate the concerns of some regarding the safety of the "stereotactic" method, allowing a better decision process among the different methods of

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Section: Resultsmentioning

confidence: 99%

Section: Study Demographicmentioning

confidence: 99%

Is SEEG safe? A systematic review and meta‐analysis of stereo‐electroencephalography–related complications

et al. 2016

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“…For Patients 1–7 and 9–10 the electrodes were placed intracranially using the Leksell stereotactic frame (Elekta AB, Stockholm, Sweden). For Patient 8, a microTargeting™ Multi‐Oblique Epilepsy STarFix Platform (FHC, Bowdoin, ME; Balanescu et al, ; Dewan et al, ; Yu, Pistol, Franklin, & Barborica, ) was used, while Patients 11–12 were implanted using the ROSA Surgical robot (Medtech, Montpellier, France). To determine the exact location of each electrode and contact, the postimplantation CT scan was co‐registered with the preimplantation MRI.…”

Section: Methodsmentioning

confidence: 99%

Illusory own body perceptions mapped in the cingulate cortex—An intracranial stimulation study

Popa

Barborică

Scholly

et al. 2019

Human Brain Mapping

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Body awareness is the result of sensory integration in the posterior parietal cortex; however, other brain structures are part of this process. Our goal is to determine how the cingulate cortex is involved in the representation of our body. We retrospectively selected patients with drug‐resistant epilepsy, explored by stereo‐electroencephalography, that had the cingulate cortex sampled outside the epileptogenic zone. The clinical effects of high‐frequency electrical stimulation were reviewed and only those sites that elicited changes related to body perception were included. Connectivity of the cingulate cortex and other cortical structures was assessed using the h2 coefficient, following a nonlinear regression analysis of the broadband EEG signal. Poststimulation changes in connectivity were compared between two sets of stimulations eliciting or not eliciting symptoms related to body awareness (interest and control groups). We included 17 stimulations from 12 patients that reported different types of body perception changes such as sensation of being pushed toward right/left/up, one limb becoming heavier/lighter, illusory sensation of movement, sensation of pressure, sensation of floating or detachment of one hemi‐body. High‐frequency stimulation in the cingulate cortex (1 anterior, 15 middle, 1 posterior part) elicits body perception changes, associated with a decreased connectivity of the dominant posterior insula and increased coupling between other structures, located particularly in the nondominant hemisphere.

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“…Bone fiducials, by serving as fixed anchor points, may allow for the planning of highly accurate and stable treatment trajectories. 19 STarFix mT platforms have been successfully used for deep brain stimulation (DBS) 9 and for epilepsy monitoring; 1,18 however, to date no studies have examined their application to LITT. In this paper we present a series of 5 patients who presented with intracranial lesions that were amenable to LITT with STarFix stereotactic guidance.…”

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confidence: 99%

Utilizing personalized stereotactic frames for laser interstitial thermal ablation of posterior fossa and mesiotemporal brain lesions: a single-institution series

Dadey

Kamath

Smyth

et al. 2016

FOC

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OBJECTIVE The precision of laser probe insertion for interstitial thermal therapy of deep-seated lesions is limited by the method of stereotactic guidance. The objective of this study was to evaluate the feasibility of customized STarFix 3D-printed stereotactic platforms to guide laser probe insertion into mesiotemporal and posterior fossa targets. METHODS The authors conducted a retrospective review of 5 patients (12–55 years of age) treated with laser interstitial thermal therapy (LITT) in which STarFix platforms were used for probe insertion. Bone fiducials were implanted in each patient's skull, and subsequent CT scans were used to guide the design of each platform and incorporate desired treatment trajectories. Once generated, the platforms were mounted on the patients' craniums and used to position the laser probe during surgery. Placement of the laser probe and the LITT procedure were monitored with intraoperative MRI. Perioperative and follow-up MRI were performed to identify and monitor changes in target lesions. RESULTS Accurate placement of the laser probe was observed in all cases. For all patients, thermal ablation was accomplished without intraoperative complications. Of the 4 patients with symptomatic lesions, 2 experienced complete resolution of symptoms, and 1 reported improved symptoms compared with baseline. CONCLUSIONS Customized stereotactic platforms were seamlessly incorporated into the authors' previously established LITT workflow and allowed for accurate treatment delivery.

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A Personalized Stereotactic Fixture for Implantation of Depth Electrodes in Stereoelectroencephalography

Cited by 41 publications

References 14 publications

Is SEEG safe? A systematic review and meta‐analysis of stereo‐electroencephalography–related complications

Is SEEG safe? A systematic review and meta‐analysis of stereo‐electroencephalography–related complications

Illusory own body perceptions mapped in the cingulate cortex—An intracranial stimulation study

Utilizing personalized stereotactic frames for laser interstitial thermal ablation of posterior fossa and mesiotemporal brain lesions: a single-institution series

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