Mapping spreading depolarisations after traumatic brain injury: a pilot clinical study protocol
Introduction Cortical spreading depolarisation (CSD) is characterised by a near-complete loss of the ionic membrane potential of cortical neurons and glia propagating across the cerebral cortex, which generates a transient suppression of spontaneous neuronal activity. CSDs have become a recognised p...
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| Format: | Article |
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BMJ Publishing Group
2022-07-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/7/e061663.full |
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| author | Anant Naik Samuel W Cramer Isabela Peña Pino Danielle Carlson Michael C Park David P Darrow |
| author_facet | Anant Naik Samuel W Cramer Isabela Peña Pino Danielle Carlson Michael C Park David P Darrow |
| author_sort | Anant Naik |
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| description | Introduction Cortical spreading depolarisation (CSD) is characterised by a near-complete loss of the ionic membrane potential of cortical neurons and glia propagating across the cerebral cortex, which generates a transient suppression of spontaneous neuronal activity. CSDs have become a recognised phenomenon that imparts ongoing secondary insults after brain injury. Studies delineating CSD generation and propagation in humans after traumatic brain injury (TBI) are lacking. Therefore, this study aims to determine the feasibility of using a multistrip electrode array to identify CSDs and characterise their propagation in space and time after TBI.Methods and analysis This pilot, prospective observational study will enrol patients with TBI requiring therapeutic craniotomy or craniectomy. Subdural electrodes will be placed for continuous electrocorticography monitoring for seizures and CSDs as a research procedure, with surrogate informed consent obtained preoperatively. The propagation of CSDs relative to structural brain pathology will be mapped using reconstructed CT and electrophysiological cross-correlations. The novel use of multiple subdural strip electrodes in conjunction with brain morphometric segmentation is hypothesised to provide sufficient spatial information to characterise CSD propagation across the cerebral cortex and identify cortical foci giving rise to CSDs.Ethics and dissemination Ethical approval for the study was obtained from the Hennepin Healthcare Research Institute’s ethics committee, HSR 17-4400, 25 October 2017 to present. Study findings will be submitted for publication in peer-reviewed journals and presented at scientific conferences.Trial registration number NCT03321370. |
| format | Article |
| id | doaj-art-2cef00cd22ac43c295295d68a7df1065 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-07-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-2cef00cd22ac43c295295d68a7df10652025-01-31T00:15:12ZengBMJ Publishing GroupBMJ Open2044-60552022-07-0112710.1136/bmjopen-2022-061663Mapping spreading depolarisations after traumatic brain injury: a pilot clinical study protocolAnant Naik0Samuel W Cramer1Isabela Peña Pino2Danielle Carlson3Michael C Park4David P Darrow5Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USADepartment of Neurosurgery, University of Minnesota Twin Cities, Minneapolis, Minnesota, USADepartment of Neurosurgery, University of Minnesota Twin Cities, Minneapolis, Minnesota, USADepartment of Neurosurgery, University of Minnesota Twin Cities, Minneapolis, Minnesota, USADepartment of Neurosurgery, University of Minnesota Twin Cities, Minneapolis, Minnesota, USANeurosurgery, University of Minnesota Medical School Twin Cities, Minneapolis, Minnesota, USAIntroduction Cortical spreading depolarisation (CSD) is characterised by a near-complete loss of the ionic membrane potential of cortical neurons and glia propagating across the cerebral cortex, which generates a transient suppression of spontaneous neuronal activity. CSDs have become a recognised phenomenon that imparts ongoing secondary insults after brain injury. Studies delineating CSD generation and propagation in humans after traumatic brain injury (TBI) are lacking. Therefore, this study aims to determine the feasibility of using a multistrip electrode array to identify CSDs and characterise their propagation in space and time after TBI.Methods and analysis This pilot, prospective observational study will enrol patients with TBI requiring therapeutic craniotomy or craniectomy. Subdural electrodes will be placed for continuous electrocorticography monitoring for seizures and CSDs as a research procedure, with surrogate informed consent obtained preoperatively. The propagation of CSDs relative to structural brain pathology will be mapped using reconstructed CT and electrophysiological cross-correlations. The novel use of multiple subdural strip electrodes in conjunction with brain morphometric segmentation is hypothesised to provide sufficient spatial information to characterise CSD propagation across the cerebral cortex and identify cortical foci giving rise to CSDs.Ethics and dissemination Ethical approval for the study was obtained from the Hennepin Healthcare Research Institute’s ethics committee, HSR 17-4400, 25 October 2017 to present. Study findings will be submitted for publication in peer-reviewed journals and presented at scientific conferences.Trial registration number NCT03321370.https://bmjopen.bmj.com/content/12/7/e061663.full |
| spellingShingle | Anant Naik Samuel W Cramer Isabela Peña Pino Danielle Carlson Michael C Park David P Darrow Mapping spreading depolarisations after traumatic brain injury: a pilot clinical study protocol BMJ Open |
| title | Mapping spreading depolarisations after traumatic brain injury: a pilot clinical study protocol |
| title_full | Mapping spreading depolarisations after traumatic brain injury: a pilot clinical study protocol |
| title_fullStr | Mapping spreading depolarisations after traumatic brain injury: a pilot clinical study protocol |
| title_full_unstemmed | Mapping spreading depolarisations after traumatic brain injury: a pilot clinical study protocol |
| title_short | Mapping spreading depolarisations after traumatic brain injury: a pilot clinical study protocol |
| title_sort | mapping spreading depolarisations after traumatic brain injury a pilot clinical study protocol |
| url | https://bmjopen.bmj.com/content/12/7/e061663.full |
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