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Jamie J. Van Gompel, Jesus Rubio, Gregory D. Cascino, Gregory A. Worrell, and Fredric B. Meyer

.9 ± 0.2 1.4 ± 0.2 <0.05 * Note that ECoG and lobectomy were significantly associated with right-sided lesions and that ECoG was more frequently used with smaller cavernomas. Ordinal and nominal variables were analyzed using chi-square analysis and continuous variables with ANOVA. p < 0.05 was considered statistically significant. No ECoG Versus ECoG Electrocorticography in our practice is most often used in cases of temporal lobe lesions given the clinical worries of associated mesial temporal seizure generation from associated cavernomas. In fact, only

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Chandan G. Reddy, Goutam G. Reddy, Hiroto Kawasaki, Hiroyuki Oya, Lee E. Miller, and Matthew A. Howard III

conduit for potential infection, although wireless technologies are undergoing testing and development. Multichannel data obtained at high sampling rates presents a problem of bandwidth and power for fully implanted systems, but several groups are currently actively engaged in addressing these challenges. 13 , 26 Keeping in mind the criticisms of both the most invasive of interfaces (the penetrating electrodes) and the least invasive (scalp EEG), some groups have proposed ECoG as a potential intermediary. Electrocorticography involves the use of subdural low

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Kai J. Miller, Dora Hermes, and Nathan P. Staff

F or patients with functional limitations, the ability to use brain signals to control an assistive medical device would greatly improve quality of life. Patients with amyotrophic lateral sclerosis (ALS) or tetraplegia, for example, have significant impairments in communication and motor control. For patients with ALS, eye tracking may provide an option for these individuals to control a device, but this technology depends on light conditions and full ocular mobility, which may be limited in the late stages of ALS. 1 Two recent studies in electrocorticography

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Mitchel S. Berger, Saadi Ghatan, Michael M. Haglund, Jill Dobbins, and George A. Ojemann

surrounding a tumor 15, 22, 30, 32 or other structural lesions such as arteriovenous malformations, 8, 35, 49 controversy remains regarding the inclusion of these peripheral epileptogenic zones in the surgical strategy. Certainly, resection of the tumor alone may result in good postoperative control of the patient's epilepsy. 9, 15–17, 21, 25 However, in patients with intractable epilepsy and low-grade gliomas, resection of the tumor without the aid of intraoperative electrocorticography (ECoG) to define epileptogenic regions may often result in only a slightly reduced

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Cyrille H. Ferrier, Eleonora Aronica, Frans S. S. Leijten, Wim G. M. Spliet, Karin Boer, Peter C. Van Rijen, and Alexander C. Van Huffelen

–demonstrated lesion location. The optimal surgical intervention consists of complete lesionectomy combined with resection of the adjacent epileptogenic area. 41 , 44 Electrocorticography is often used to identify cortical areas that show active spiking to tailor the resection. 44 Cavernomas consist of endothelium-lined vascular channels without mural muscular or elastic fibers, within a matrix of collagenous tissue that lacks neuronal elements. 42 Failure of the capillaries to form tight junctions results in chronic slow bleeding into the brain parenchyma 37 so that the

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Guy M. McKhann II, Julie Schoenfeld-McNeill, Donald E. Born, Michael M. Haglund, and George A. Ojemann

: 185–194, 1998 7. Binnie CD , McBride MC , Polkey CE , et al : Electrocorticography and stimulation. Acta Neurol Scand Suppl 152 : 74 – 82 , 1994 Binnie CD, McBride MC, Polkey CE, et al: Electrocorticography and stimulation. Acta Neurol Scand Suppl 152: 74–82, 1994 8. Cascino GD , Trenerry MR , Jack CR Jr , et al : Electrocorticography and temporal lobe epilepsy: relationship to quantitative MRI and operative outcome. Epilepsia 36 : 692 – 696 , 1995 Cascino GD, Trenerry MR, Jack CR Jr, et al: Electrocorticography and temporal lobe

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Robert Lesko, Barbora Benova, Petr Jezdik, Petr Liby, Alena Jahodova, Martin Kudr, Michal Tichy, Josef Zamecnik, and Pavel Krsek

electrocorticography (ECoG), comparison of preoperative and postoperative MRI, and histopathological assessment of surgical margins. In patients with nonlesional focal epilepsy, this verification is based solely on intracranial EEG study data 7 and histopathological assessment. Intraoperative ECoG directly detects epileptiform discharges originating in the epileptogenic cortex during epilepsy surgery. Preresection ECoG, performed immediately before initial resection, aims to determine the extent of the irritative zone. Postresection ECoG aims to identify residual epileptiform

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Kurt E. Weaver, Andrew Poliakov, Edward J. Novotny, Jared D. Olson, Thomas J. Grabowski, and Jeffrey G. Ojemann

the best marker of focal cortical activity, 18 thereby serving as a metric of local computation across a number of functional domains, such as sensory processing, attention, memory, and motor control. 15 Although the mechanistic and physiological origins of HG signals are debated, 5 , 17 it is widely held that high-frequency responses represent some fundamental physiological process of human cortical function. 21 , 28 Subdural electrocorticography (ECoG) is exquisitely sensitive to task-evoked modulation of HGP. By sampling directly from the cortical surface

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Webster H. Pilcher, Daniel L. Silbergeld, Mitchel S. Berger, and George A. Ojemann

patients revealed that epileptogenic cortex was free of tumor invasion, while tumor-associated cortex was nondischarging. Fig. 3. Brain maps of 12 patients (Cases 1 to 12) with temporal and frontal lobe gangliogliomas depicting tumor volume and location, as derived from computerized tomography, magnetic resonance imaging, and intraoperative ultrasound study. The extent of epileptogenic zone as defined by intraoperative electrocorticography (ECoG) or by extraoperative recordings using subdural strip or grid electrodes is also depicted. Areas of cortical

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Fedor Panov, Emily Levin, Coralie de Hemptinne, Nicole C. Swann, Salman Qasim, Svjetlana Miocinovic, Jill L. Ostrem, and Philip A. Starr

hemiparesis that had improved by the last follow-up. TABLE 3. Complications in 200 cases of movement disorders surgery in which electrocorticography was utilized Complication No. of Cases Reported Rate in the DBS Literature Outcome Infection 5 (2.5%) Up to 10% 12 , 35 , 41 2 reimplanted after antibiotic course, 2 awaiting reimplantation, & 1 repeat infection (explanted) Chronic subdural hematoma 1 (0.5%) 0.8–3% 15 , 30 Surgical evacuation w/return to baseline Intraparenchymal hematoma 1 (0.5%) 0.5–2.2% 35 , 43