Intraoperative neurophysiology for motor-related cortecies and functional recovery after injury

运动相关皮质和损伤后功能恢复的术中神经生理学

基本信息

批准号：
17591535
负责人：
FUKAYA Chikashi
金额：
$ 2.28万
依托单位：
Nihon University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2005
资助国家：
日本
起止时间：
2005 至 2007
项目状态：
已结题

项目摘要

On tumor resection close to the motor pathway, several types of functional mapping such as preoperative neuroimaging and intraoperative electrophysiological techniques have been extensively used in the past few decades to decrease postoperative morbidity. In particular, evoked-potential recording following a direct electrical stimulation of the cortex has been used as an intraoperative mapping and monitoring method during surgery.The corticospinal D-wave has been confirmed as an indicator for the mapping of M1(primary motor cortex) and for monitoring CST (corticospinal tract) function during surgery. We already reported the functional outcomes due to SMA (supplementary motor cortex) and PM (premotor cortex) impairment are considerably different from that of the M1 impairment. Motor deficit caused by damage to SMA and/or PM is often expected to be compensated, and patients often fully recover in a few months. Therefore, to differentiate the M1 from other motor-related corticies is important. As previously reported, responses from muscles can be evoked by stimulating not only M1 and CST but also SMA, PM, and probably their descending fibers. This feature is unfavorable for achieving maximum tumor resection with minimum postoperative deficits because The corticospinal D-wave can be recorded only when M1 is stimulated.On the other hand, attention has mainly been paid functional mapping of the cortex. However, intramedullary tumors such as glial tumors commonly invade subcortical structures as well as the cortices ; thus, definitive deficits may occur because of surgical impairments to eloquent pathways running through subcortical structures. Subcortical mapping using the D-wave elicited by monopolar stimulation can provide useful information that can be used to prevent postoperative motor deficit. In particular, the potential of this method for determining the distance of the stimulation point from the CST using D-wave amplitude is promising.

在接近电动通路的肿瘤切除术上，在过去的几十年中，已广泛使用了几种类型的功能映射，例如术前神经成像和术中电生理技术，以降低术后发病率。特别是，在手术过程中直接电刺激皮质的直接电刺激后，诱发的电位记录已被用作术中映射和监测方法。已确认皮质脊髓D波被确认为M1（原发性运动皮层）和监测CST（皮层脊髓裂纹）功能的指标。我们已经报道了由于SMA（补充运动皮层）和PM（前皮层）损伤引起的功能结果与M1损伤的损伤有很大不同。通常预计由SMA和/或PM损坏造成的运动不足会得到补偿，并且患者通常会在几个月内完全康复。因此，要区分M1与其他与运动相关的皮层区分很重要。如前所述，不仅可以刺激M1和CST，还可以刺激SMA，PM及其下降纤维来引起肌肉的反应。此功能对于使用最小术后缺陷实现最大的肿瘤切除是不利的，因为只有在刺激M1时才能记录皮层脊髓D波。另一方面，注意力层主要是对皮层的功能映射。然而，诸如神经胶质肿瘤之类的髓内肿瘤通常会侵入皮质下结构以及皮质。因此，由于对穿过皮层下结构的雄辩途径的手术障碍，可能会出现确定的缺陷。使用单极刺激引起的D波的皮层映射可以提供有用的信息，可用于防止术后运动不足。特别是，使用D波振幅确定刺激点与CST的距离的潜力是有希望的。

项目成果

期刊论文数量（0）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

ジストニアの臨床像と脳深部刺激療法の効果

肌张力障碍的临床特征及脑深部电刺激治疗的效果

DOI：
发表时间：
2006
期刊：
機能的脳神経外科 45(1)
影响因子：
0
作者：
Oshima H;Katayama Y;Fukaya C;Kano T;Kobayashi K;Yamamoto T;Suzuki Y.;Nagaoka T;Fukaya C;深谷親;片山容一;Katayama Y;Fukaya C;Katayama Y;Kano T;深谷親
通讯作者：
深谷親

脳深部刺激療法、脳神経外科大系10, 定位・機能神経外科(片山容一編)

脑深部电刺激疗法，神经外科10科，立体定向/功能神经外科（片山洋一编辑）