Benovitski Y B, Lai A, McGowan C C, Burns O, Maxim V, Nayagam D A X, Millard R, Rathbone G D, le Chevoir M A, Williams R A, Grayden D B, May C N, Murphy M, D'Souza W J, Cook M J, Williams C E
The Bionics Institute, East Melbourne, Victoria, Australia.
Department of Medicine, St. Vincent's Hospital, The University of Melbourne, Melbourne, Victoria, Australia.
Epilepsy Res. 2017 Sep;135:29-37. doi: 10.1016/j.eplepsyres.2017.06.003. Epub 2017 Jul 5.
Minimally-invasive approaches are needed for long-term reliable Electroencephalography (EEG) recordings to assist with epilepsy diagnosis, investigation and more naturalistic monitoring. This study compared three methods for long-term implantation of sub-scalp EEG electrodes.
Three types of electrodes (disk, ring, and peg) were fabricated from biocompatible materials and implanted under the scalp in five ambulatory ewes for 3months. Disk electrodes were inserted into sub-pericranial pockets. Ring electrodes were tunneled under the scalp. Peg electrodes were inserted into the skull, close to the dura. EEG was continuously monitored wirelessly. High resolution CT imaging, histopathology, and impedance measurements were used to assess the status of the electrodes at the end of the study.
EEG amplitude was larger in the peg compared with the disk and ring electrodes (p<0.05). Similarly, chewing artifacts were lower in the peg electrodes (p<0.05). Electrode impedance increased after long-term implantation particularly for those within the bone (p<0.01). Micro-CT scans indicated that all electrodes stayed within the sub-scalp layers. All pegs remained within the burr holes as implanted with no evidence of extrusion. Eight of 10 disks partially eroded into the bone by 1.0mm from the surface of the skull. The ring arrays remained within the sub-scalp layers close to implantation site. Histology revealed that the electrodes were encapsulated in a thin fibrous tissue adjacent to the pericranium. Overlying this was a loose connective layer and scalp. Erosion into the bone occurred under the rim of the sub-pericranial disk electrodes.
The results indicate that the peg electrodes provided high quality EEG, mechanical stability, and lower chewing artifact. Whereas, ring electrode arrays tunneled under the scalp enable minimal surgical techniques to be used for implantation and removal.
长期可靠的脑电图(EEG)记录需要微创方法来辅助癫痫诊断、研究及更自然的监测。本研究比较了三种用于长期植入头皮下EEG电极的方法。
用生物相容性材料制作三种类型的电极(盘状、环状和栓状),并将其植入五只活动的母羊头皮下3个月。盘状电极插入颅骨膜下袋中。环状电极在头皮下穿行。栓状电极插入靠近硬脑膜的颅骨中。通过无线方式持续监测脑电图。在研究结束时,使用高分辨率CT成像、组织病理学和阻抗测量来评估电极的状态。
与盘状和环状电极相比,栓状电极的脑电图振幅更大(p<0.05)。同样,栓状电极的咀嚼伪迹更低(p<0.05)。长期植入后电极阻抗增加,尤其是骨内电极(p<0.01)。微型CT扫描表明所有电极都停留在头皮下层。所有栓状电极都如植入时一样留在钻孔内,没有挤出的迹象。10个盘状电极中有8个从颅骨表面向骨内部分侵蚀了1.0mm。环状电极阵列留在靠近植入部位的头皮下层。组织学显示电极被包裹在颅骨膜附近的一层薄纤维组织中。其上方是一层疏松结缔组织和头皮。颅骨膜下盘状电极边缘下方出现了向骨内的侵蚀。
结果表明,栓状电极能提供高质量脑电图、机械稳定性且咀嚼伪迹更低。而在头皮下穿行的环状电极阵列使得植入和取出可采用微创技术。