PRESURGICAL LOCALIZATION OF PRIMARY MOTOR CORTEX IN PEDIATRIC PATIENTS WITH BRAIN LESIONS BY THE USE OF SPATIALLY FILTERED MAGNETOENCEPHALOGRAPHY
PRESURGICAL LOCALIZATION OF PRIMARY MOTOR CORTEX IN PEDIATRIC PATIENTS WITH BRAIN LESIONS BY THE USE OF SPATIALLY FILTERED MAGNETOENCEPHALOGRAPHY
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DOI：
10.1227/01.neu.0000316433.10913.32
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发表时间：
2009-03-01
期刊：
影响因子：
4.8
通讯作者：
Pang, Eliabeth W.
中科院分区：
文献类型：
--
作者：
Gaetz, William;Cheyne, Douglas;Pang, Eliabeth W.
目的：本研究的目的是确认空间过滤脑磁图在感觉器-转子皮层区域局灶性病变的儿科患者的初级运动皮质术前定位的有效性。方法：我们记录了10例接受局灶性脑病变切除术术前评估的儿童患者（年龄范围7-18岁，平均年龄12.5岁）的运动相关脑磁图活动。参与者对视觉提示做出了左右食指的短暂运动。用一种新开发的波束形成空间滤波算法对平均脑反应中的运动前场分量进行了定位。10例患者中有5例术中进行了运动皮层的皮质测绘。结果：95%的病例（10例中有9例来自非病变半球，10例中有10例来自病变半球），肌电图时间锁定的运动场成功定位于手部区初级运动皮层对应的皮质区域。术中皮质电刺激在所有测试病例中激活了运动场共同记录的皮质源位置的预期肌肉（n = 5）。通过这些方法，我们还发现，占位性肿瘤引起的感觉运动皮质移位并不会干扰运动皮质的定位。结论：我们得出结论，使用空间过滤脑磁成像技术可以可靠地进行初级运动皮质的无创定位，该技术为外科指导提供了可靠而准确的运动皮质功能测量。
OBJECTIVE: The objective of this Study Was to confirm the efficacy of spatially filtered magnetoencephalography for the preoperative localization of primary motor cortex in pediatric patients with focal lesions in the region Of the sensorin-rotor cortex,METHODS: We recorded movement-related magnetoencephalographic activity in 10 pediatric patients (age range, 7-18 years; mean age, 12.5 years) undergoing presurgical evaluation for focal brain lesion resection. Participants made transient movements of the right and left index finger in response to a Visual cue. The premovement motor field component in the averaged brain response was localized will) a newly developed beamformer spatial filter algorithm. Cortical mapping of motor cortex intraoperatively was conducted in 5 of the 10 patients.RESULTS: The motor field time-locked to electromyography onset was successfully localized to cortical areas corresponding to the hand region primary motor cortex in 95% of cases (9 of 10 from nonlesional hemisphere; 10 of 10 from lesional hemisphere). Intraoperative electrocortical stimulation activated the expected muscles at motor field coregistered cortical Source locations in all cases tested (n = 5). Using these methods, we also found that displacement of the sensorimotor cortex by space-occupying tumors did riot interfere with the localization of motor cortex,CONCLUSION: We conclude that noninvasive localization of the primary motor cortex can be reliably performed by using spatially filtered magnetoencephalography techniques, which provide a robust and accurate measurement of motor cortical function for the purpose Of Surgical guidance.