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FIH Clinical Investigation of Graphene Electrodes for Brain Mapping

Not Applicable
Not yet recruiting
Conditions
Brain Tumor
Glioma
Interventions
Device: INBRAIN Graphene Cortical Interface
Registration Number
NCT06368310
Lead Sponsor
University of Manchester
Brief Summary

The goal of this clinical investigation of a medical device is to test the safety of graphene based electrodes when used during surgery for resection of brain tumors. The main questions that it aims to answer are:

* To understand the safety of these new electrodes when used during brain tumor surgery (primary objective);

* To assess the quality of the brain signals recorded with the new electrodes, their ability to stimulate the brain, how stable their function is over the duration of an operation, and their suitability for use in the operating theatre (secondary objectives).

Participants will undergo tumor surgery as usual with the study electrodes being tested alongside a standard monitoring system. If they are awake for part of their surgery they may be asked to complete specific tasks such as naming objects from a list modified for the study. They will be monitored subsequently for any complications including undergoing an additional MRI scan 6 weeks after their surgery.

Detailed Description

During surgical operations within the brain such as the removal of a tumor, electrodes are commonly used to map specific brain functions or monitor brain activity. These are most commonly flexible plastic devices with embedded metallic contacts that allow electrical activity in the brain to be detected and measured. They may also be used to stimulate precise areas of the brain to either trigger or block a response such as the contraction of a muscle. This allows the surgeon to define which regions of the brain are involved in controlling critical functions such as movement or speech so that these areas can be protected during the operation.

There remain limitations with the design and physical characteristics of commercially available electrodes for use during brain operations. These include the limited ability of conventional materials to fold over the complex shape of the brain and the need to use comparatively large metallic contacts to detect the tiny electrical signals. This study will be the first to introduce a new generation of electrodes which have been designed to overcome these limitations. They are extremely thin and flexible allowing them to follow the surface of the brain and to be used in locations within and around the brain for which the standard electrodes are unsuitable. The contact surfaces that detect electrical activity and enable and stimulate the brain have been replaced with graphene which is a novel carbon-based material. The use of graphene allows electrodes to be made that are more sensitive to the tiny electrical signals of the brain. This means that they can be much smaller and closer together providing increased detail in the recording and potentially enabling signals to be detected that would previously have required such long recordings that they could not be used to guide decision making during surgery.

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
8
Inclusion Criteria
  • Solitary supratentorial tumor radiologically consistent with glioma (intrinsic primary brain tumor) on standard diagnostic MRI;
  • Planned for surgery under awake conditions or under general anesthesia with intra-operative electrocorticography (ECoG);
  • English as first language for those subjects with tumors associated with language areas;
  • Karnofsky performance score > 70 and World Health Organization (WHO) performance status score ≤ 1;
  • Willing and able to understand and provide informed consent for participating in the study.
Exclusion Criteria
  • Contraindications to magnetic resonance imaging (e.g., incompatible implanted devices);
  • Previous cranial surgery or radiotherapy;
  • Subjects expected to undergo craniotomy of less than 5 cm in maximum diameter (bone to bone)
  • Known extracranial malignant neoplasm;
  • Pregnant or lactating women;
  • Renal impairment sufficient to limit Gadolinium administration (EGFR <60 ml/min)
  • For those subjects with tumors associated with language areas, any contraindication which could preclude them from performing the whole awake intra operative tasks at the discretion of the Investigator (e.g., language function not suitable for monitoring tasks)

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Intervention ArmINBRAIN Graphene Cortical InterfacePatients with suspected gliomas (intrinsic primary brain tumors) in whom surgical resection under general anesthesia with neurophysiological monitoring or under awake conditions where language mapping is planned.
Primary Outcome Measures
NameTimeMethod
To evaluate the preliminary safety of the investigational device for its intended useThrough study completion, an average of 3 months

All adverse events (including, but not limited to, adverse device events)

Secondary Outcome Measures
NameTimeMethod
Assess the ability of the device to record signals from the brainDuring surgical procedure

Performance of detecting signals from the brain by sensing of electrical brain activity

Evaluate the ability of the device to provide functional stimulation of the brainDuring surgical procedure

Performance of functional stimulation of the brain by inducing evoked motor responses measured as peripheral muscle electromyography (EMG)

Assess stability of sensing and stimulating electrodesDuring surgical procedure

Stability of electrodes by evaluation of impedance measurements over time

Evaluate device usability - an assessment by questionnaire of the operating surgeon's impression of the suitability of the device for sensing and stimulation during brain tumor surgeryDuring surgical procedure

Study specific questionnaire to be completed by the operating surgeon including ease of handling, positioning and removal of the electrode

Trial Locations

Locations (1)

Manchester Centre for Clinical Neurosciences, Northern Care Alliance NHS Foundation Trust

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Salford, Greater Manchester, United Kingdom

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