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Journal of Long-Term Effects of Medical Implants
SJR: 0.332 SNIP: 0.491 CiteScore™: 0.89

ISSN Print: 1050-6934
ISSN Online: 1940-4379

Journal of Long-Term Effects of Medical Implants

DOI: 10.1615/JLongTermEffMedImplants.v18.i1.480
50 pages

Abstract of "A Clinical Trial of an Advanced Diagnostic Biomedical Device for Epilepsy Patients"

Patricia A. Broderick
Dep.of Physiology&Pharmacology, CUNY Med. School, Sophie Davis School, CCNY; Dep. of Biology and Psychology, CUNY Graduate School; Dep. of Neurology, NYU Medical School, Langone Med. Center, & NYU Comprehensive Med.Center, NY
Werner K. Doyle
Department of Neurology, NYU Medical School, Langone Medical Center, & NYU Comprehensive Medical Center, New York, NY 10031
Steven V. Pacia
Department of Neurology, NYU Medical School, Langone Medical Center, & NYU Comprehensive Medical Center, New York, NY 10031
Ruben I. Kuzniecky
Department of Neurology, NYU Medical School, Langone Medical Center, & NYU Comprehensive Medical Center, New York, NY 10031
Orrin Devinsky
Department of Neurology, NYU Medical School, Langone Medical Center, & NYU Comprehensive Medical Center, New York, NY 10031
Edwin H. Kolodny
Department of Neurology, NYU Medical School, Langone Medical Center, & NYU Comprehensive Medical Center, New York, NY 10031

ABSTRACT

We are developing an advanced biomedical device for the diagnosis of epilepsy in patients during surgery. This micronanotechnologic device represents a significant advance in biomedical engineering and bioimaging. For the first time, the neurochemistry underlying normal and pathologic neuronal function in the intact brain of the epilepsy patient is studied in vivo in NYU Tisch Hospital under Internal Review Board approval, with unique biosensors patented by CUNY and NYU. Using semiderivative voltammetric circuits, neuromolecular imaging (NMI), with the Broderick probe biosensor, selective detection of specific neurotransmitters in discrete parts of intact brain is imaged within a temporal resolution of seconds. Our studies begin with presurgical evaluation of the patient with EEG monitoring wherein the site of cortical resection is delineated and subdural grid and strip electrodes are placed on the surface of the brain to identify the epileptogenic cortex. Then, biosensors, with a diameter five times less than epilepsy depth electrodes for invasive EEG, are placed by direct visualization in the exposed cortical region with and without epileptic spike activity in regions destined for resection. About 10 recordings with [X]-irradiated (11.6−12.7 kGy) laminar biocompatible carbon-based laurate biosensors are taken at cortical depths of microns to less than 2 mm for a 20−30 min time period. In our first anterior temporal lobe epilepsy patient, results showed that dopamine (DA), homovanillic acid (HVA) (metabolite of DA), serotonin (5-HT), L-tryptophan (L-TP) (precursor to 5-HT), and peptides (dynorphin and somatostatin) were present in the patient's neocortex (current resolution: nanoamperes). Intraoperative images were verified by comparison with our 14 year empirical database on epilepsy (Br.Res., 2000,2001; Bioimaging in Neurodegeneration, Springer, Humana Press, NJ, 2005; Clinical U.S. Patent, #7,112,319,2006; Clinical & Preclinical U.S. Patent, Pending, 2009). Future studies involve the prolonged use of biosensors in patients undergoing intracranial EEG studies in the NYU Tisch Intensive Care Unit. The present studies chart a course for safe and cutting-edge opportunities to characterize neurochemical profiles for epilepsy patients with partial seizures. The studies also provide discovery of novel surgical and pharmacologic strategies to alleviate the burden of seizures in our epilepsy patients.