Detection of after-discharges during intraoperative functional brain mapping in awake brain tumor surgery using a novel high-density circular grid.
Detection of after-discharges during intraoperative functional brain mapping in awake brain tumor surgery using a novel high-density circular grid.
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使用新型高密度圆形网格在清醒脑肿瘤手术的术中功能性脑映射过程中检测后放电。
DOI：
10.1016/j.clinph.2019.12.416
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发表时间：
2020
期刊：
影响因子：
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通讯作者：
Quinones-Hinojosa,Alfredo
中科院分区：
文献类型：
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作者：
Tatum,WilliamO;McKay,JakeH;ReFaey,Karim;Feyissa,AntenehM;Ryan,Dan;Ritaccio,Anthony;Middlebrooks,Erik;Yelvington,Kirsten;Roth,Grayson;Acton,Emily;Grewal,Sanjeet;Chaichana,Kaisorn;Quinones-Hinojosa,Alfredo
目的评价脑功能标测（functional brain mapping，FBM）术中使用新型高密度圆形网格检测皮层脑电图（electrocorticography，ECoG）后放电（after-discharge，AD）的效果。方法脑胶质瘤手术期间（10/2016 ~ 5/2019），FBM使用22通道圆形网格记录AD，并与传统条形电极进行比较。AD的检测，持续时间，幅度，形态，组织学，方向，和临床signs.Results32例（平均年龄54.2岁; r = 30-75）与胶质瘤（WHO等级II-IV; 20级IV）进行了手术。与IDH-1突变体患者相比，野生型患者（p < 0.0001）使用更多接触时FBM期间AD的可能性更大（p = 0.0001）。在较低刺激强度（3.14 mA vs 4.13 mA; p = 0.09）下，更多传感器倾向于参与圆形网格vs条带（6.61 vs 3.43; p = 0.16）检测到的AD。切除前皮质刺激次数无差异（38.9 mA vs 47.9 mA; p = 0.26）。大于10秒的AD分别为32.5秒（圆形网格）与58.4（条）（p = 0.12）。野生型患者比IDH-1突变患者更容易诱发AD。SignificanceCircular grid在术中FBM检测AD时提供高分辨率ECoG。
ObjectiveTo evaluate intraoperative use of a novel high-density circular grid in detecting after-discharges (AD) on electrocorticography (ECoG) during functional brain mapping (FBM).MethodsFBM during glioma surgery (10/2016 to 5/2019) recorded ADs using a 22-channel circular grid compared to conventional strip electrodes. ADs were analyzed for detection, duration, amplitude, morphology, histology, direction, and clinical signs.ResultsThirty-two patients (mean age 54.2 years; r = 30–75) with glioma (WHO grade II-IV; 20 grade IV) had surgery. ADs during FBM were more likely in patients with wild-type as opposed to IDH-1 mutants (p < 0.0001) using more contacts compared with linear strip electrodes (p = 0.0001). More sensors tended to be involved in ADs detected by the circular grid vs strips (6.61 vs 3.43; p = 0.16) at lower stimulus intensity (3.14 mA vs 4.13 mA; p = 0.09). No difference in the number of cortical stimulations before resection was present (38.9 mA vs 47.9 mA; p = 0.26). ADs longer than 10 seconds were 32.5 seconds (circular grid) vs 58.4 (strips) (p = 0.12).ConclusionsHigh-density circular grids detect ADs in 360 degrees during FBM for glioma resection. Provocation of ADs was more likely in patients with wild-type than IDH-1 mutation.SignificanceCircular grids offer high-resolution ECoG during intraoperative FBM for detection of ADs.