Clinical Accuracy of Customized Stereotactic Fixtures for Stereoelectroencephalography

Yu, Hong; Pistol, Constantin; Franklin, Ronald D.; Barborică, Andrei

doi:10.1016/j.wneu.2017.09.089

Cited by 20 publications

(19 citation statements)

References 18 publications

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“…The median and IQR values of accuracy at the EP and TP in the M3 cohort were similar to those achieved using a novel implantation approach based on the individualized frame. 11 Unsurpris-ingly, they were inferior to the accuracy achieved using robot-guided implantation, a key feature of which is an outstanding stability of the drill in relation to the patient's head. 1 The improvement in accuracy is evident ( Table 1, Fig.…”

Section: Discussionmentioning

confidence: 99%

“…5,8 Errors of depth insertion are recognized 10 and may exceed 10 mm. 11 Another factor that may affect the reported integral accuracy of the implantation is bending of the electrode during insertion. This effect is well recognized 1,3 been systematically quantified.…”

Section: Clinical Articlementioning

confidence: 99%

“…Accuracy is typically reported using summary statistics (mean/median, confidence intervals/interquartile range [IQR]). Few studies report outliers and maximum errors 3,11 which, even with very accurate techniques (such as robot guidance and a patient-specific frame), may exceed 5 mm and 10 mm, respectively, for the integral accuracy at the TP. Understanding the factors contributing to inaccuracy is important for the safety of implantation surgery and for minimizing risk.…”

Section: Clinical Articlementioning

confidence: 99%

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Increasing the accuracy of 3D EEG implantations

Rodionov

O’Keeffe

Nowell

et al. 2020

Journal of Neurosurgery

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OBJECTIVEThe accuracy of stereoelectroencephalography (SEEG) electrode implantation is an important factor in maximizing its safety. The authors established a quality assurance (QA) process to aid advances in implantation accuracy.METHODSThe accuracy of three consecutive modifications of a frameless implantation technique was quantified in three cohorts comprising 22, 8, and 23 consecutive patients. The modifications of the technique aimed to increase accuracy of the bolt placement.RESULTSThe lateral shift of the axis of the implanted bolt at the level of the planned entry point was reduced from a mean of 3.0 ± 1.6 mm to 1.4 ± 0.8 mm. The lateral shift of the axis of the implanted bolt at the level of the planned target point was reduced from a mean of 3.8 ± 2.5 mm to 1.6 ± 0.9 mm.CONCLUSIONSThis QA framework helped to isolate and quantify the factors introducing inaccuracy in SEEG implantation, and to monitor ongoing accuracy and the effect of technique modifications.

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Section: Discussionmentioning

confidence: 99%

Section: Clinical Articlementioning

confidence: 99%

Section: Clinical Articlementioning

confidence: 99%

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Increasing the accuracy of 3D EEG implantations

Rodionov

O’Keeffe

Nowell

et al. 2020

Journal of Neurosurgery

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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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“…SEEG electrodes are inserted under general anesthesia, using either a frame-based or a frameless technique. Following the introduction of neuronavigation in the 2000s, various frameless devices were developed or adapted for SEEG electrode implantation to take advantage of its versatility; a double-chuck articulated arm was developed at the MNI 4) and others have adapted various commercially available devices, such as Varioguide (BrainLab AG, Feldkirchen, Germany), 23) Guide Frame DT (Minneapolis, MN, USA), 24) Vertek arm (Medtronics), 25) and microTargeting Epilepsy Platform (FHC Inc., Bowdoin, ME, USA) 26) for the implantation using percutaneous drilling. The advance in robotics technology such as ROSA (Zimmer Biomet, Warsaw, IN, USA), 27,28) NeuroMate (Renishaw, New Mills, UK), 5) iSys1 miniature robotic device (Medtronics) 29) have further enhanced the development of the frameless technique.…”

Section: Technical Considerations During Seeg Electrode Placementmentioning

confidence: 99%

Technical Aspects of SEEG and Its Interpretation in the Delineation of the Epileptogenic Zone

Khoo

Hall

Dubeau

et al. 2020

Neurol. Med. Chir.(Tokyo)

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Stereo-electroencephalography (SEEG) has gained global popularity in recent years. In Japan, a country in which invasive studies using subdural electrodes (SDEs) have been the mainstream, SEEG has been approved for insurance coverage in 2020 and is expected to gain in popularity. Some concepts supporting SEEG methodology are fundamentally different from that of SDE studies. Clinicians interested in utilizing SEEG in their practice should be aware of those aspects in which they differ. Success in utilizing the SEEG methodology relies heavily on the construction of an a priori hypothesis regarding the putative seizure onset zone (SOZ) and propagation. This article covers the technical and theoretical aspects of SEEG, including the surgical techniques and precautions, hypothesis construction, and the interpretation of the recording, all with the aim of providing an introductory guide to SEEG.

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Clinical Accuracy of Customized Stereotactic Fixtures for Stereoelectroencephalography

Cited by 20 publications

References 18 publications

Increasing the accuracy of 3D EEG implantations

Increasing the accuracy of 3D EEG implantations

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

Technical Aspects of SEEG and Its Interpretation in the Delineation of the Epileptogenic Zone

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