Enhancing Precision in Epilepsy Monitoring with Telescopic Hybrid M^3 Electrodes

For patients with focal drug-resistant epilepsy, surgical remediation can be a hopeful last resort treatment option, but only if enough clinical signs can point to an epileptogenic tissue region. Subdural grids offer ample cortical surface area coverage to evaluate multiple regions of interest, yet they lack the spatial resolution typical of penetrating electrodes. Additionally, subthreshold stimulation through subdural grids is a stable source for detecting eloquent cortex surrounding potential epileptic tissue. Researchers have each tried introducing microelectrodes to increase the spatial resolution but ran into connectivity challenges as the desired surface area increased. Meanwhile, clinical hybrid options have shown promise by combining multiple electrode sizes, maintaining surface area coverage with an increased spatial resolution where necessary. However, a benchtop method to quantify spatial resolution or test signal summation, without the complexity of an in vivo study, has not been found in the literature; a subdural grid in gel solution has functioned previously but without a published method. Thus, a novel hybrid electrode array with a telescopic configuration including three electrode geometries, called the M$^3$ array, is proposed to maintain cortical surface area coverage and provide spatial clarity in regions of interest using precision microfabrication techniques. Electrophysiological recording with this array should enhance the clinical signal portfolio without changing how clinicians interface with the broad surface data from macros. Additionally, this would provide a source for simultaneous recording and stimulation from the same location due to the telescopic nature of the design. A novel benchtop test method should remove complexity from in vivo tests while allowing direct comparison of recording capabilities of different cortical surface electrodes. Implementing the proposed M$^3$ electrode array in intracranial monitoring improves the current technology without much compromise, enhancing patient outcomes, reducing risks, and encouraging swift clinical translation.