Multi-component intrinsic brain activities as a safe alternative to cortical stimulation for sensori-motor mapping in neurosurgery.
Multi-component intrinsic brain activities as a safe alternative to cortical stimulation for sensori-motor mapping in neurosurgery.
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多成分内在大脑活动作为神经外科感觉运动映射皮质刺激的安全替代方案。
DOI：
10.1016/j.clinph.2018.06.007
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发表时间：
2018
期刊：
影响因子：
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通讯作者：
Ikeda A.
中科院分区：
文献类型：
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作者：
Neshige S;Matsuhashi M;Kobayashi K;Sakurai T;Shimotake A;Hitomi T;Kikuchi T;Yoshida K;Kunieda T;Matsumoto R;Takahashi R;Miyamoto S;Maruyama H;Matsumoto M;Ikeda A.
目的评估基于多组分皮质电图（ECoG）的“广谱、脑内活动”定位初级感觉-运动区（S1-M1）的可行性。方法对2011 - 2016年在京都大学医院接受1514个覆盖脑周皮质的硬膜下电极植入的14例癫痫患者进行评估。我们进行了多分量、基于ecog的映射（带通滤波器，0.016-300/600 Hz），包括对单个分量的组合分析：运动相关皮质电位（< 0.5-1 Hz）、事件相关同步（76-200 Hz）和事件相关去同步（8-24 Hz），以识别S1-M1。通过与单组分作图和皮层电刺激（ECS）的比较，评估了多组分作图的可行性。结果在54个功能区评价中，三个单分量图一致时，ecg图与ECS图的定位一致性率显著高于三个单分量图不一致时（运动图p < 0.001，感觉图p = 0.02）。与ECS相比，多组分定位显示高灵敏度（89-90%）和特异性（94-97%）。结论基于全谱、多组分的ecg图谱定位是可行的，相对于ECS具有较高的敏感性和特异性。这种安全（非刺激）的定位策略，替代ECS，将允许临床医生在切除手术前排除脑功能的可能性。
ObjectiveTo assess the feasibility of multi-component electrocorticography (ECoG)-based mapping using “wide-spectrum, intrinsic-brain activities” for identifying the primary sensori-motor area (S1-M1).MethodsWe evaluated 14 epilepsy patients with 1514 subdural electrodes implantation covering the perirolandic cortices at Kyoto University Hospital between 2011 and 2016. We performed multi-component, ECoG-based mapping (band-pass filter, 0.016–300/600 Hz) involving combined analyses of the single components: movement-related cortical potential (<0.5–1 Hz), event-related synchronization (76–200 Hz), and event-related de-synchronization (8–24 Hz) to identify the S1-M1. The feasibility of multi-component mapping was assessed through comparisons with single-component mapping and electrical cortical stimulation (ECS).ResultsAmong 54 functional areas evaluation, ECoG-based maps showed significantly higher rate of localization concordances with ECS maps when the three single-component maps were consistent than when those were inconsistent with each other (p < 0.001 in motor, and p = 0.02 in sensory mappings). Multi-component mapping revealed high sensitivity (89–90%) and specificity (94–97%) as compared with ECS.ConclusionsWide-spectrum, multi-component ECoG-based mapping is feasible, having high sensitivity/specificity relative to ECS.SignificanceThis safe (non-stimulus) mapping strategy, alternative to ECS, would allow clinicians to rule in/out the possibility of brain function prior to resection surgery.