A Standardized Electrode Nomenclature for Stereoelectroencephalography Applications

Abstract

Purpose: Stereoelectroencephalography (SEEG) is widely performed on individuals with medically refractory epilepsy for whom invasive seizure localization is desired. Despite increasing adoption in many centers across the world, no standardized electrode naming convention exists, generating confusion among both clinical and research teams. Methods:We have developed a novel nomenclature, named the Standardized Electrode Nomenclature for SEEG Applications system. Concise, unique, informative, and unambiguous labels provide information about entry point, deep targets, and relationships between electrodes. Inter-rater agreement was evaluated by comparing original electrode names from 10 randomly sampled cases (including 136 electrodes) with those prospectively assigned by four additional blinded raters. Results:The Standardized Electrode Nomenclature for SEEG Application system was prospectively implemented in 40 consecutive patients undergoing SEEG monitoring at our institution, creating unique electrode names in all cases, and facilitating implantation design, SEEG recording and mapping interpretation, and treatment planning among neurosurgeons, neurologists, and neurophysiologists. The inter-rater percent agreement for electrode names among two neurosurgeons, two epilepsy neurologists, and one neurosurgical fellow was 97.5%.Conclusions: This standardized naming convention, Standardized Electrode Nomenclature for SEEG Application, provides a simple, concise, reproducible, and informative method for specifying the target(s) and relative position of each SEEG electrode in each patient, allowing for successful sharing of information in both the clinical and research settings. General adoption of this nomenclature could pave the way for improved communication and collaboration between institutions.

Somatic Mosaicism in PIK3CA Variant Correlates With Stereoelectroencephalography-Derived Electrophysiology

“…Electrodes were labeled using the standardized electrode nomenclature for stereoelectroencephalography applications (SENSA). 12 Five typical tonic seizures, numerous myoclonic seizures, and several clusters of epileptic spasms were captured. Ictal onset involved the left anterior middle and inferior frontal gyrus corresponding to electrodes F2aOFa (contacts 3–8; 12-15), F2b (contacts 9–12), and F3aOFb (contacts 8–10), with early spread to the posterior frontal region, insula, and cingulate with later propagation to the left parietotemporal lobes (eFigure 1, links.lww.com/NXG/A663 ).…”

In Search of a Common Language: The Standardized Electrode Nomenclature for Stereoelectroencephalography Applications

“…This system uniquely names each electrode in a concise, informative, and highly reproducible manner. In a prospective study by Stone et al, 13 the inter-rater percent agreement for electrode names among neurosurgeons and epileptologists was 97.5%. SENSA's straightforward and logical naming rules maximize the value gained from a short string of characters (on average 2-6), and each electrode's name conveys a threedimensional construct of its trajectory by encoding its anatomical entry point, cortical target(s), and relative position to other electrodes in the anterior-posterior (A-P) plane.…”

“…This system uniquely names each electrode in a concise, informative, and highly reproducible manner. In a prospective study by Stone et al, 13 the inter-rater percent agreement for electrode names among neurosurgeons and epileptologists was 97.5%.…”

A hierarchical anatomical framework and workflow for organizing stereotactic encephalography in epilepsy

“…To mitigate this, some groups have advocated for the use of orthogonal lead placements and “typical” trajectories (Bourdillon et al, 2018; Faraji et al, 2020; Khoo et al, 2020). Others, meanwhile, have created labeling algorithms to standardize SEEG nomenclature based upon lead trajectories (Stone et al, 2020). Unfortunately, the former approach may constrain the use of SEEG in a flexible and patient‐specific manner, while the proposed labeling schemes are rather complex and unintuitive, limiting widespread adoption.…”