Brain Tumor Adult
Conditions
Brief summary
The clinical investigation evaluates whether speech can be decoded from neural activity recorded with cortical surface electrocorticography (ECoG) electrodes during awake brain tumor surgery. Neural signals and voice recordings are collected while patients perform a picture naming task as part of standard intraoperative mapping. The study assesses the ability of machine learning algorithms to predict the named item from intraoperative electrophysiological recordings.
Detailed description
Patients with severe speech and motor impairments often lose the ability to communicate, detrimentally affecting their quality of life. Invasive brain-computer interfaces (BCIs) have shown promise in restoring lost speech functionalities by decoding neural activity of intended or attempted speech. However, the systems with the most promising results rely on highly invasive micro-electrode arrays that tend to irritate the brain tissue leading to inflammation, tissue scarring and ultimately, loss of signal. A promising long-term alternative is intracranial electrode strips/grids that rest on the surface of the brain without having to penetrate the cortex. The contact density of standard strips/grids used for electrophysiological mapping is very low (1 contact/cm2 compared to 100 contacts/cm2), however, a new generation of electrode strips/grids offer decent contact density closing the distance with micro-electrode arrays. In order to determine if the contact density of cortical surface electrode grids is sufficient for decoding speech, we aim to record and decode neural activity of tumor patients performing a picture naming task during awake surgeries, as these operations offer the only opportunity to test the use of cortical surface electrodes for neural speech decoding.
Interventions
PROCEDUREPlacement of high-density electrodes on cortical surface during awake surgery
INBRAIN Graphene Cortical Interface (Non-CE-marked Class III )high-density graphene ECoG grid placed on cortical surface for up to 2 hours during awake surgery. Recording only, no stimulation.
PROCEDUREPlacement of INBRAIN Graphene Cortical Interface on cortical surface
INBRAIN Graphene Cortical Interface (Non-CE-marked Class III )high-density graphene ECoG grid placed on cortical surface for up to 2 hours during awake brain surgery. Recording only, no stimulation.
PROCEDUREPlacement of low-density electodes during awake brain surgery
DIXI C10-12BIOM and WISE WCS00-4S10-000 (CE-marked Class III) low-density ECoG strips placed on cortical surface for up to 2 hours during awake surgery. Recording only, no stimulation.
Sponsors
Assistance Publique - Hôpitaux de Paris
Study design
Allocation
RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 84 Years
Healthy volunteers
No
Inclusion criteria
1. Patients 18 years of age or older. 2. Patients with a brain tumor requiring surgery under "awake" conditions with intraoperative placement of ECoG electrodes at Lariboisière Hospital. 3 -Patients with tumor locations close to language processing areas. 4 -Patients having given consent during the interview with the neurosurgeon.
Exclusion criteria
1. Patients with severe cognitive impairments that would prevent understanding and performing the image-naming task, 2. Patients with major psychiatric disorders that could affect their ability to participate in the research, 3. Patients with inoperable tumors, 4. Patients with tumor locations incompatible with safe or effective placement of ECoG electrodes, 5. Females that are breastfeeding or females with childbearing potential with positive urine pregnancy test or not using adequate contraception, 6. Patients unable to provide informed consent due to cognitive or language limitations, 7. Patients who have any electrical stimulator or any active implanted medical device that uses high magnetic or electrical currents (e.g. patients with pacemaker defibrillator, neurostimulator, drugs pumps, retinal and cochlear device), 8. Any wearable medical device that may cause troubles to the investigational devices and injuries to the participants, 9. Patients with medical contraindications to general or local anesthesia required for surgery, 10. Patients with an active infection or infectious skin lesions on the scalp, 11. Patients with a current use or a recent history of illicit drug(s) use or alcohol abuse (defined as frequent or daily consumption of more than four alcoholic drinks per day), 12. Patients with contraindications to any surgical procedure, 13. Patients undergoing treatment with anticoagulants, platelet aggregation inhibitors, or non-steroidal anti-inflammatory drugs, 14. Patients who decline to participate in the study, 15. Any specially protected person: adults protected by law; persons hospitalized without their consent, at the request of a third party or ex officio; persons deprived of their liberty by a judicial decision, 16. Participation in another interventional study or being in the exclusion period at the end of a previous study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Primary outcome Measure | Up to 12 months after the last patient's intraoperative recording | The primary metric for evaluating the success of the project is the accuracy of the machine learning algorithms in decoding neural activity to predict the named item by the patient. Achieving an Area Under the Curve (AUC) value of greater than 0.9 indicates high predictive performance. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Secondary Outcome Measure | Up to 12 months after the last patient's intraoperative recording | The evaluation criterion is to identify axono-cortical evoked potentials (ACEPs) with a signal- to-noise ratio \> 1. The parameters consist of all recordings made by surface electrodes during axonal electrical stimulation at 1 Hz. On each channel, averaging will be performed, synchronized with the 1 Hz stimulation. |
Countries
France
Contacts
CONTACTEmmanuel MANDONNET
CONTACTAnne-Lise GIRAUD
Outcome results
None listed