Letter to the editor in response to: A profile on the WISE cortical strip for intraoperative neurophysiological monitoring

KEYWORDS:

• Direct cortical stimulation
• high-frequency oscillation
• neurosurgery
• sensory evoked potentials
• signal-to-noise ratio

I am writing to express my appreciation for the insightful article, ‘A profile on the WISE cortical strip for intraoperative neurophysiological monitoring,’ by Johannes Sarnthein and Marian C. Neidert Published in Expert Review of Medical Devices [1]. The authors have made a significant contribution to the field of neurosurgery by highlighting the capabilities of the WISE cortical strip in enhancing intraoperative neurophysiological monitoring. The findings presented in the paper illuminate the significance of employing advanced electrode technology to enhance signal-to-noise ratio and provide real-time feedback to neurosurgeons during critical procedures. The emphasis on the performance standards and usability of ECoG electrodes, particularly in the context of low impedance for noise reduction, is a pivotal takeaway from this study.

Nevertheless, despite the promising aspects of the WISE cortical strip, there are critical limitations that need to be addressed for its optimal utilization in clinical practice. Firstly, the trade-off between electrode contact density and impedance poses a challenge in achieving both high signal quality and ease of placement [2]. Secondly, the need for specialized expertise in neurophysiology, anatomy, imaging modalities, and neurosurgery for implementing advanced documentation systems may limit the widespread adoption of these technologies in neurosurgery centers [3]. Finally, the clinical relevance of recording high-frequency oscillations and the impact of improved ECoG electrodes on postsurgical patient outcomes remain areas that require further investigation [4,5].

In light of the aforementioned findings and limitations, it is of the utmost importance to consider several recommendations for future research and development in the field of intraoperative neurophysiological monitoring. Firstly, efforts should be directed toward optimizing electrode design in order to achieve an optimal balance between contact density, impedance, and usability [2]. It is of paramount importance that neurophysiologists, neurosurgeons, and imaging specialists collaborate in order to facilitate the successful integration of advanced documentation systems into neurosurgical practice [3]. Furthermore, future studies should concentrate on evaluating the clinical significance of recording high-frequency oscillations and assessing the long-term impact of using improved ECoG electrodes on patient outcomes [4,5]. By implementing these recommendations, researchers can further enhance the efficacy and applicability of the WISE cortical strip and similar technologies in neurosurgical settings.

In conclusion, the paper by Sarnthein and Neidert provides valuable insights into the potential of the WISE cortical strip for intraoperative neurophysiological monitoring. By acknowledging the findings, limitations, and recommendations outlined in this letter, the field of neurosurgery can advance toward more effective and patient-centered practices.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Additional information

Funding

This paper was not funded.