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Feasibility and safety of electrocorticography monitoring after acute brain injury to detect cortical spreading depolarisation, a prospective observational study in a neurological intensive care unit.

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Τίτλος: Feasibility and safety of electrocorticography monitoring after acute brain injury to detect cortical spreading depolarisation, a prospective observational study in a neurological intensive care unit.
Συγγραφείς: Balança B; Lyon Neuroscience Research Centre, CRNL - CH Le Vinatier - Bâtiment 462 - Neurocampus, 95 Bd Pinel, 69500 Bron, France; Hospices Civils de Lyon, Hôpital Pierre Wertheimer, 59 Bd Pinel, 69500 Bron, France. Electronic address: baptiste.balanca@chu-lyon.fr., Ghibaudo V; Lyon Neuroscience Research Centre, CRNL - CH Le Vinatier - Bâtiment 462 - Neurocampus, 95 Bd Pinel, 69500 Bron, France., Bado J; Hospices Civils de Lyon, Hôpital Pierre Wertheimer, 59 Bd Pinel, 69500 Bron, France., Berthiller J; Hospices Civils de Lyon, Hôpital Pierre Wertheimer, 59 Bd Pinel, 69500 Bron, France., Ritzenthaler T; Hospices Civils de Lyon, Hôpital Pierre Wertheimer, 59 Bd Pinel, 69500 Bron, France., Gobert F; Lyon Neuroscience Research Centre, CRNL - CH Le Vinatier - Bâtiment 462 - Neurocampus, 95 Bd Pinel, 69500 Bron, France; Hospices Civils de Lyon, Hôpital Pierre Wertheimer, 59 Bd Pinel, 69500 Bron, France., Bapteste L; Hospices Civils de Lyon, Hôpital Pierre Wertheimer, 59 Bd Pinel, 69500 Bron, France., Carrillon R; Hospices Civils de Lyon, Hôpital Pierre Wertheimer, 59 Bd Pinel, 69500 Bron, France., Bodonian C; Hospices Civils de Lyon, Hôpital Pierre Wertheimer, 59 Bd Pinel, 69500 Bron, France., Contard F; Hospices Civils de Lyon, Hôpital Pierre Wertheimer, 59 Bd Pinel, 69500 Bron, France., Percevault G; Lyon Neuroscience Research Centre, CRNL - CH Le Vinatier - Bâtiment 462 - Neurocampus, 95 Bd Pinel, 69500 Bron, France., Marinesco S; Lyon Neuroscience Research Centre, CRNL - CH Le Vinatier - Bâtiment 462 - Neurocampus, 95 Bd Pinel, 69500 Bron, France., Dreier JP; Centre for stroke research Berlin, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitépl. 1, 10117 Berlin, Germany; Department of Experimental Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitépl. 1, 10117 Berlin, Germany; Department of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitépl. 1, 10117 Berlin, Germany; Bernstein Center for Computational Neuroscience Berlin, Philippstr. 13, Haus 6, 10115 Berlin, Germany; Einstein Centre for Neurosciences Berlin, Charitépl. 1, 10117 Berlin, Germany., Woitzik J; Universitätsklinik für Neurochirurgie, Oldenburg, Steinweg 13 - 17, 26122 Oldenburg, Germany., Haegelen C; Hospices Civils de Lyon, Hôpital Pierre Wertheimer, 59 Bd Pinel, 69500 Bron, France., Rheims S; Lyon Neuroscience Research Centre, CRNL - CH Le Vinatier - Bâtiment 462 - Neurocampus, 95 Bd Pinel, 69500 Bron, France; Hospices Civils de Lyon, Hôpital Pierre Wertheimer, 59 Bd Pinel, 69500 Bron, France., Dumot C; Hospices Civils de Lyon, Hôpital Pierre Wertheimer, 59 Bd Pinel, 69500 Bron, France., Dailler F; Hospices Civils de Lyon, Hôpital Pierre Wertheimer, 59 Bd Pinel, 69500 Bron, France., Berhouma M; University Hospital of Dijon Burgundy, 2 Bd Maréchal de Lattre de Tassigny, 21000 Dijon, France; ICMUB - CNRS 6302 - University of Burgundy Europe, Dijon, France.
Πηγή: Anaesthesia, critical care & pain medicine [Anaesth Crit Care Pain Med] 2026 Jul; Vol. 45 (4), pp. 101669. Date of Electronic Publication: 2025 Nov 13.
Τύπος έκδοσης: Journal Article; Observational Study
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Published by Elsevier Masson SAS on behalf of the Société française d'anesthésie et de réanimation (Sfar) Country of Publication: France NLM ID: 101652401 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2352-5568 (Electronic) Linking ISSN: 23525568 NLM ISO Abbreviation: Anaesth Crit Care Pain Med Subsets: MEDLINE
Imprint Name(s): Original Publication: Issy-les-Moulineaux cedex, France : Published by Elsevier Masson SAS on behalf of the Société française d'anesthésie et de réanimation (Sfar), [2015]-
Ιατρικοί όροι (MeSH): Electrocorticography*/methods , Electrocorticography*/adverse effects , Cortical Spreading Depression*/physiology , Subarachnoid Hemorrhage*/physiopathology , Brain Injuries*/physiopathology , Brain Injuries, Traumatic*/physiopathology, Monitoring, Physiologic/methods ; Critical Care/methods ; Humans ; Prospective Studies ; Female ; Feasibility Studies ; Male ; Intensive Care Units ; Middle Aged ; Adult ; Aged
Περίληψη: Background: Neurological intensive care units (neuro-ICU) prioritise maintaining homeostasis and monitoring for secondary brain injuries. These injuries can worsen primary lesions, such as those caused by subarachnoid haemorrhage (SAH) or traumatic brain injury (TBI). Cortical spreading depolarisations (SDs) are both markers and mechanisms of secondary brain damage. We evaluated the feasibility and safety of electrocorticography monitoring to identify SD in a neuro-ICU without SD monitoring experience.
Methods: We conducted a single-centre prospective study on adults admitted with either SAH or severe TBI. Each participant's involvement lasted up to 7 days for TBI, and up to 15 days for SAH. The primary endpoint was the availability of a high-quality electrocorticography signal, with or without SD, for ≥12 h per patient. The adverse events of interest were neurological infection, skin infection, cerebrospinal fluid leak, peri-electrode intracranial bleeding, and all-cause mortality. We used subdural Wyler-strip or Spencer-type electrodes, or Intraparenchymal Spencer-type electrodes in patients not requiring surgery.
Outcomes: A total of 20 patients were included (SAH [n = 12] or a TBI [n = 8]). The primary endpoint was achieved in 19 patients monitored for a median [IQR] of 6 days [4-9]. At least 1 SD was observed in 10 patients (50%; SAH: n = 6/12, TBI: n = 4/8). There was 1 cerebrospinal fluid leakage; 1 local skin infection with a Spencer-type intracortical electrode; and 1 EVD-related ventriculitis with a subdural Spencer-type electrode.
Conclusions: Monitoring SD with electrocorticography is feasible and safe in a neuro-ICU with no prior experience. Further studies are needed to optimise techniques and assess clinical outcomes.
Study Registration: ClinicalTrials.gov (NCT04585503). Registered 7 October 2020.
(Copyright © 2025 The Authors. Published by Elsevier Masson SAS.. All rights reserved.)
Competing Interests: Declaration of competing interest The authors declare that they have no competing interests.
Contributed Indexing: Keywords: Electrocorticography; Intensive care; Neuromonitoring; Spreading depolarisation
Molecular Sequence: ClinicalTrials.gov NCT04585503
Entry Date(s): Date Created: 20251115 Date Completed: 20260624 Latest Revision: 20260625
Update Code: 20260626
DOI: 10.1016/j.accpm.2025.101669
PMID: 41241268
Βάση Δεδομένων: MEDLINE
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  Data: Feasibility and safety of electrocorticography monitoring after acute brain injury to detect cortical spreading depolarisation, a prospective observational study in a neurological intensive care unit.
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  Data: <searchLink fieldCode="AU" term="%22Balança+B%22">Balança B</searchLink>; Lyon Neuroscience Research Centre, CRNL - CH Le Vinatier - Bâtiment 462 - Neurocampus, 95 Bd Pinel, 69500 Bron, France; Hospices Civils de Lyon, Hôpital Pierre Wertheimer, 59 Bd Pinel, 69500 Bron, France. Electronic address: baptiste.balanca@chu-lyon.fr.<br /><searchLink fieldCode="AU" term="%22Ghibaudo+V%22">Ghibaudo V</searchLink>; Lyon Neuroscience Research Centre, CRNL - CH Le Vinatier - Bâtiment 462 - Neurocampus, 95 Bd Pinel, 69500 Bron, France.<br /><searchLink fieldCode="AU" term="%22Bado+J%22">Bado J</searchLink>; Hospices Civils de Lyon, Hôpital Pierre Wertheimer, 59 Bd Pinel, 69500 Bron, France.<br /><searchLink fieldCode="AU" term="%22Berthiller+J%22">Berthiller J</searchLink>; Hospices Civils de Lyon, Hôpital Pierre Wertheimer, 59 Bd Pinel, 69500 Bron, France.<br /><searchLink fieldCode="AU" term="%22Ritzenthaler+T%22">Ritzenthaler T</searchLink>; Hospices Civils de Lyon, Hôpital Pierre Wertheimer, 59 Bd Pinel, 69500 Bron, France.<br /><searchLink fieldCode="AU" term="%22Gobert+F%22">Gobert F</searchLink>; Lyon Neuroscience Research Centre, CRNL - CH Le Vinatier - Bâtiment 462 - Neurocampus, 95 Bd Pinel, 69500 Bron, France; Hospices Civils de Lyon, Hôpital Pierre Wertheimer, 59 Bd Pinel, 69500 Bron, France.<br /><searchLink fieldCode="AU" term="%22Bapteste+L%22">Bapteste L</searchLink>; Hospices Civils de Lyon, Hôpital Pierre Wertheimer, 59 Bd Pinel, 69500 Bron, France.<br /><searchLink fieldCode="AU" term="%22Carrillon+R%22">Carrillon R</searchLink>; Hospices Civils de Lyon, Hôpital Pierre Wertheimer, 59 Bd Pinel, 69500 Bron, France.<br /><searchLink fieldCode="AU" term="%22Bodonian+C%22">Bodonian C</searchLink>; Hospices Civils de Lyon, Hôpital Pierre Wertheimer, 59 Bd Pinel, 69500 Bron, France.<br /><searchLink fieldCode="AU" term="%22Contard+F%22">Contard F</searchLink>; Hospices Civils de Lyon, Hôpital Pierre Wertheimer, 59 Bd Pinel, 69500 Bron, France.<br /><searchLink fieldCode="AU" term="%22Percevault+G%22">Percevault G</searchLink>; Lyon Neuroscience Research Centre, CRNL - CH Le Vinatier - Bâtiment 462 - Neurocampus, 95 Bd Pinel, 69500 Bron, France.<br /><searchLink fieldCode="AU" term="%22Marinesco+S%22">Marinesco S</searchLink>; Lyon Neuroscience Research Centre, CRNL - CH Le Vinatier - Bâtiment 462 - Neurocampus, 95 Bd Pinel, 69500 Bron, France.<br /><searchLink fieldCode="AU" term="%22Dreier+JP%22">Dreier JP</searchLink>; Centre for stroke research Berlin, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitépl. 1, 10117 Berlin, Germany; Department of Experimental Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitépl. 1, 10117 Berlin, Germany; Department of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitépl. 1, 10117 Berlin, Germany; Bernstein Center for Computational Neuroscience Berlin, Philippstr. 13, Haus 6, 10115 Berlin, Germany; Einstein Centre for Neurosciences Berlin, Charitépl. 1, 10117 Berlin, Germany.<br /><searchLink fieldCode="AU" term="%22Woitzik+J%22">Woitzik J</searchLink>; Universitätsklinik für Neurochirurgie, Oldenburg, Steinweg 13 - 17, 26122 Oldenburg, Germany.<br /><searchLink fieldCode="AU" term="%22Haegelen+C%22">Haegelen C</searchLink>; Hospices Civils de Lyon, Hôpital Pierre Wertheimer, 59 Bd Pinel, 69500 Bron, France.<br /><searchLink fieldCode="AU" term="%22Rheims+S%22">Rheims S</searchLink>; Lyon Neuroscience Research Centre, CRNL - CH Le Vinatier - Bâtiment 462 - Neurocampus, 95 Bd Pinel, 69500 Bron, France; Hospices Civils de Lyon, Hôpital Pierre Wertheimer, 59 Bd Pinel, 69500 Bron, France.<br /><searchLink fieldCode="AU" term="%22Dumot+C%22">Dumot C</searchLink>; Hospices Civils de Lyon, Hôpital Pierre Wertheimer, 59 Bd Pinel, 69500 Bron, France.<br /><searchLink fieldCode="AU" term="%22Dailler+F%22">Dailler F</searchLink>; Hospices Civils de Lyon, Hôpital Pierre Wertheimer, 59 Bd Pinel, 69500 Bron, France.<br /><searchLink fieldCode="AU" term="%22Berhouma+M%22">Berhouma M</searchLink>; University Hospital of Dijon Burgundy, 2 Bd Maréchal de Lattre de Tassigny, 21000 Dijon, France; ICMUB - CNRS 6302 - University of Burgundy Europe, Dijon, France.
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  Data: Background: Neurological intensive care units (neuro-ICU) prioritise maintaining homeostasis and monitoring for secondary brain injuries. These injuries can worsen primary lesions, such as those caused by subarachnoid haemorrhage (SAH) or traumatic brain injury (TBI). Cortical spreading depolarisations (SDs) are both markers and mechanisms of secondary brain damage. We evaluated the feasibility and safety of electrocorticography monitoring to identify SD in a neuro-ICU without SD monitoring experience.<br />Methods: We conducted a single-centre prospective study on adults admitted with either SAH or severe TBI. Each participant's involvement lasted up to 7 days for TBI, and up to 15 days for SAH. The primary endpoint was the availability of a high-quality electrocorticography signal, with or without SD, for ≥12 h per patient. The adverse events of interest were neurological infection, skin infection, cerebrospinal fluid leak, peri-electrode intracranial bleeding, and all-cause mortality. We used subdural Wyler-strip or Spencer-type electrodes, or Intraparenchymal Spencer-type electrodes in patients not requiring surgery.<br />Outcomes: A total of 20 patients were included (SAH [n = 12] or a TBI [n = 8]). The primary endpoint was achieved in 19 patients monitored for a median [IQR] of 6 days [4-9]. At least 1 SD was observed in 10 patients (50%; SAH: n = 6/12, TBI: n = 4/8). There was 1 cerebrospinal fluid leakage; 1 local skin infection with a Spencer-type intracortical electrode; and 1 EVD-related ventriculitis with a subdural Spencer-type electrode.<br />Conclusions: Monitoring SD with electrocorticography is feasible and safe in a neuro-ICU with no prior experience. Further studies are needed to optimise techniques and assess clinical outcomes.<br />Study Registration: ClinicalTrials.gov (NCT04585503). Registered 7 October 2020.<br /> (Copyright © 2025 The Authors. Published by Elsevier Masson SAS.. All rights reserved.)
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  Data: Declaration of competing interest The authors declare that they have no competing interests.
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          Titles:
            – TitleFull: Anaesthesia, critical care & pain medicine
              Type: main
ResultId 1