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Long-term deep intracerebral microelectrode recordings in patients with drug-resistant epilepsy: Proposed guidelines based on 10-year experience
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International audience. Purpose: Human neuronal activity, recorded in vivo from microelectrodes, may offer valuable insights into phys-iological mechanisms underlying human cognition and pathophysiological mechanisms of brain diseases, in par-ticular epilepsy. Continuous and long-term recordings are necessary to monitor non predictable pathological andphysiological activities like seizures or sleep. Because of their high impedance, microelectrodes are more sensitiveto noise than macroelectrodes. Low noise levels are crucial to detect action potentials from background noise,and to further isolate single neuron activities. Therefore, long-term recordings of multi-unit activity remains achallenge. We shared here our experience with microelectrode recordings and our efforts to reduce noise levelsin order to improve signal quality. We also provided detailed technical guidelines for the connection, recording,imaging and signal analysis of microelectrode recordings.Results: During the last 10 years, we implanted 122 bundles of Behnke-Fried hybrid macro-microelectrodes, in56 patients with pharmacoresistant focal epilepsy. Microbundles were implanted in the temporal lobe (74%), aswell as frontal (15%), parietal (6%) and occipital (5%) lobes. Low noise levels depended on our technical setup.The noise reduction was mainly obtained after electrical insulation of the patient’s recording room and the use ofa reinforced microelectrode model, reaching median root mean square values of 5.8 μV. Seventy percent of thebundles could record multi-units activities (MUA), on around 3 out of 8 wires per bundle and for an average of12 days. Seizures were recorded by microelectrodes in 91% of patients, when recorded continuously, and MUAwere recorded during seizures for 75 % of the patients after the insulation of the room. Technical guidelinesare proposed for (i) electrode tails manipulation and protection during surgical bandage and connection to bothclinical and research amplifiers, (ii) electrical insulation of the patient’s recording room and shielding, (iii) dataacquisition and storage, and (iv) single-units activities analysis
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