## Protocol Section
### Identification Module
**NCT ID:** NCT06116279

**Brief Title:** First-in-human Experience Using Novel Ultraflexible Low-impedance Electrode Arrays: an IDEAL Stage 1 Study

**Official Title:** First-in-human Experience Using Novel Ultraflexible Low-impedance Electrode Arrays: an IDEAL Stage 1 Study

#### Organization Study ID Info
**ID:** 21BI27
#### Organization
**Class:** OTHER
**Full Name:** Great Ormond Street Hospital for Children NHS Foundation Trust
### Status Module
#### Completion Date
**Date:** 2025-08-01

**Type:** ESTIMATED

#### Expanded Access Info
#### Last Update Post Date
**Date:** 2023-11-03

**Type:** ACTUAL

**Last Update Submit Date:** 2023-11-02

**Overall Status:** NOT_YET_RECRUITING

#### Primary Completion Date
**Date:** 2025-02-01

**Type:** ESTIMATED

#### Start Date
**Date:** 2024-02-01

**Type:** ESTIMATED

**Status Verified Date:** 2023-11

#### Study First Post Date
**Date:** 2023-11-03
**Type:** ACTUAL
**Study First Submit Date:** 2023-07-26
**Study First Submit QC Date:** 2023-11-02
### Sponsor Collaborators Module

#### Lead Sponsor

**Class:** OTHER

**Name:** Great Ormond Street Hospital for Children NHS Foundation Trust

#### Responsible Party

**Type:** SPONSOR

### Oversight Module

**Is FDA Regulated Device:** False

**Is FDA Regulated Drug:** False

**Oversight Has DMC:** True

### Description Module

**Brief Summary:** The goal of this first-in-human study is to evaluate a novel ultraflexible microelectrode in children undergoing neurosurgery to remove tissue that causes epilepsy (seizures) in focal cortical dysplasia (FCD) or long-term epilepsy-associated tumours (LEAT).

The main questions it aims to answer are:

1. The safety and feasibility of the novel microelectrode into current operative workflow
2. The unique electrophysiological tissue signatures in FCD or LEAT

**Detailed Description:** Epilepsy affects 100,000 people under 25. Many children with epilepsy also have a learning disability or developmental problems and 25-30% continue to have seizures despite best medical treatment.

Neuromodulation or brain stimulation is the delivery of electricity to the brain cells. It may alter the brain activity and overall brain connectivity and currently is rarely used as a treatment for epilepsy. However, it has the potential to reduce the number of seizures and improve other problems that children with epilepsy may have such as concentration, memory and learning. 'Precision neuromodulation', which involves individually tailored treatments requires us to identify where in the brain to stimulate and what the best settings are in each individual. A limitation of current neuromodulation treatment is limited understanding of the abnormal signatures of electrical activity in abnormal tissue.

The investigators have developed a novel electrode that can record signals from the brain at higher resolution than current electrodes. The 2 micrometer, ultraflexible, low-impedance electrode arrays are smaller, less damaging, and provide multiple contacts at multiple depths. The investigators propose a first-in-human study to investigate the feasibility and safety of using these electrodes in patients undergoing surgery for epilepsy - either focal cortical dysplasia (FCD) or long-term associated epilepsy tumours (LEAT).

The investigators will insert the electrode into brain tissue that is going to be removed as part of the planned surgery. The extent of tissue damage caused by insertion will be examined, and whether the electrode is able to capture signals at difference scales from the brain will be assessed; this includes signals from an area of tissue (termed local field potential) and signals from single nerve cells (termed single unit recordings). If safe, it will lay the foundation to use these electrodes in future precision neuromodulation platforms that can be applied to epilepsy and other neurological diseases.

### Conditions Module

**Conditions:**

- Epilepsy

- Focal Cortical Dysplasia

**Keywords:**

- Epilepsy

- FCD

- LEAT

- Neurosurgery

- Microelectrode

- Local field potential

- Epileptic zone

### Design Module

#### Design Info

**Allocation:** NA

**Intervention Model:** SINGLE_GROUP

**Intervention Model Description:** The investigators will adhere to the internationally accepted five-stage Idea, Development, Evaluation, Assessment, Long-term study (IDEAL) framework for novel surgical device innovation. An IDEAL Stage 1 study requires a highly-selected patient group (n=6) and focuses on novel device innovation feasibility and safety. Adhering to the IDEAL framework will facilitate the development and evaluation of the novel device in a logical manner that balances innovation and safety.

##### Masking Info

**Masking:** NONE

**Primary Purpose:** DEVICE_FEASIBILITY

#### Enrollment Info

**Count:** 6

**Type:** ESTIMATED

**Phases:**

- NA

**Study Type:** INTERVENTIONAL

### Arms Interventions Module

#### Arm Group 1

**Description:** During the surgical procedure, following exposure of the brain via a craniotomy, the novel electrodes will be inserted into tissue planned for resection. This will be targeted using the existing neuronavigation software that is being used during the surgery and may be augmented by intraoperative ultrasound, also a common adjunct used in these surgeries. Following insertion of the electrode, the cables will be connected to a specialised (portable) amplifier inside the operating theatre and 15 minutes of data will be recoded. The electrodes will then be removed and the surgical resection will then proceed as planned. The content of the recordings will not be available in real-time and will not be used to inform or change the surgical resection plan in any way.

**Intervention Names:**

- Device: Insertion of electrode during planned neurosurgery for epilepsy

**Label:** Insertion of electrode during planned neurosurgery for epilepsy

**Type:** EXPERIMENTAL

### Interventions

#### Intervention 1

**Arm Group Labels:**

- Insertion of electrode during planned neurosurgery for epilepsy

**Description:** A novel, 300 micrometer, ultraflexible, low-impedance electrode proposes to cause minimal parenchymal (brain tissue) damage, and provide multiple contacts at multiple depths to allow unit-level recordings for a period of 15 minutes.

**Name:** Insertion of electrode during planned neurosurgery for epilepsy

**Type:** DEVICE

### Outcomes Module

#### Primary Outcomes

**Description:** Document total length of set up and recording with electrode (recorded in minutes)

**Measure:** Feasibility of novel electrode into current operative workflow

**Time Frame:** At operation

#### Secondary Outcomes

**Description:** Neuropathologists will perform haematoxylin and eosin histological (H\&E), luxol fast blue, and neutral red to describe the insertion tract lesion and neocortical cytoarchitecture

**Measure:** Resected tissue assessed histologically for damage from novel electrode

**Time Frame:** 4 weeks following operation

**Description:** The data obtained from intraoperative recording will be analysed by computational neuroscientists

**Measure:** Analysis of recorded electrophysiological data from intraoperative recording by novel electrode

**Time Frame:** 6 months

**Description:** Intraoperative events occur (haemorrhage, seizure, stroke)

**Measure:** Safety of novel electrode insertion and recording

**Time Frame:** At operation

### Eligibility Module

**Eligibility Criteria:** Inclusion Criteria:

1. Radiologically visible epileptogenic lesion (focal cortical dysplasia or long-term epilepsy associated tumour) undergoing planned resective surgery

Exclusion Criteria:

1. Unable to provide informed consent

**Healthy Volunteers:** True

**Maximum Age:** 18 Years

**Minimum Age:** 3 Months

**Sex:** ALL

**Standard Ages:**

- CHILD

- ADULT

### Contacts Locations Module

#### Central Contacts

**Contact 1:**

**Email:** martin.tisdall@gosh.nhs.uk

**Name:** Martin Tisdall, MD FRCS

**Phone:** 07726780817

**Role:** CONTACT

#### Locations

**Location 1:**

**City:** London

**Contacts:**

***Contact 1:***

- **Email:** martin.tisdall@gosh.nhs.uk

- **Name:** Martin Tisdall, MD FRCS

- **Phone:** 07726780817

- **Role:** CONTACT

**Country:** United Kingdom

**Facility:** Great Ormond Street Hospital

**Zip:** WC1N 3JH

#### Overall Officials

**Official 1:**

**Affiliation:** Great Ormond Street Hospital

**Name:** Martin Tisdall, MD FRCS

**Role:** PRINCIPAL_INVESTIGATOR

## Derived Section

### Condition Browse Module - Ancestors

- ID: D000001927

- Term: Brain Diseases

- ID: D000002493

- Term: Central Nervous System Diseases

- ID: D000009422

- Term: Nervous System Diseases

- ID: D000009421

- Term: Nervous System Malformations

- ID: D000000013

- Term: Congenital Abnormalities

- ID: D000065703

- Term: Malformations of Cortical Development, Group I

### Condition Browse Module - Browse Branches

- Abbrev: BC10

- Name: Nervous System Diseases

- Abbrev: All

- Name: All Conditions

- Abbrev: BC16

- Name: Diseases and Abnormalities at or Before Birth

### Condition Browse Module - Browse Leaves

- ID: M7983

- Name: Epilepsy

- Relevance: HIGH

- As Found: Epilepsy

- ID: M2907

- Name: Focal Cortical Dysplasia

- Relevance: HIGH

- As Found: Focal Cortical Dysplasia

- ID: M12

- Name: Congenital Abnormalities

- Relevance: LOW

- As Found: Unknown

- ID: M27589

- Name: Malformations of Cortical Development

- Relevance: HIGH

- As Found: Cortical Dysplasia

- ID: M5204

- Name: Brain Diseases

- Relevance: LOW

- As Found: Unknown

- ID: M5742

- Name: Central Nervous System Diseases

- Relevance: LOW

- As Found: Unknown

- ID: M12365

- Name: Nervous System Malformations

- Relevance: LOW

- As Found: Unknown

### Condition Browse Module - Meshes

- ID: D000004827

- Term: Epilepsy

- ID: D000054220

- Term: Malformations of Cortical Development

- ID: D000092222

- Term: Focal Cortical Dysplasia

### Misc Info Module

- Version Holder: 2024-05-24
