Usefulness of intraoperative electrical subcortical mapping during surgery for low-grade gliomas located within eloquent brain regions: functional results in a consecutive series of 103 patients

Duffau, Hugues; Laurent, Césari; Denvil, Dominique; Sichez, Nicole; Gatignol, Peggy; Taillandier, Luc; Lopes, Manuel; Mitchell, M.-C.; Roche, S.; Muller, Jean-Charles; Bitar, Ahmad W.; Sichez, Jean‐Pierre; Effenterre, R. Van

doi:10.3171/jns.2003.98.4.0764

Cited by 460 publications

(260 citation statements)

References 127 publications

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“…Н. Duffau и соавт. [37] также использует силу тока 2 мА и считают метод прямой ЭС безопасным, точным и надежным для идентификации проводя-щих путей. J. Gonzalez-Darder и соавт.…”

Section: Discussionunclassified

“…ДТ-трактография -диффузионно-тензорная трактография ТК МВП -транскраниальные моторные вызванные потенциалы ПТ -пирамидный тракт ЭС -электрическая стимуляция пользуется субкортикальная прямая ЭС [13][14][15]. Для мониторирования функций ПТ во время опера-ции используются транскраниальные моторные вы-званные потенциалы (ТК МВП) [16,17].…”

Section: список сокращенийunclassified

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Diffusion tensor imaging tractography and intraoperative neurophysiological monitoring in surgery of intracranial tumors located near the pyramidal tract

et al. 2016

Vopr. neirokhir.

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Section: Discussionunclassified

Section: список сокращенийunclassified

Diffusion tensor imaging tractography and intraoperative neurophysiological monitoring in surgery of intracranial tumors located near the pyramidal tract

et al. 2016

Vopr. neirokhir.

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“…The connections are language pathways that have a form of fibres. Because fMRI and PET have little sensitivity for the subcortex, (Hirsch et al 2000), language mapping of this part of the brain is the only way to identify and spare functional subcortical structures involved in language as well as language tracts than run through the white matter (Vinas et al 1997;Duffau et al 2003;Bello et al 2006). …”

Section: Language Tests For Ies Of the Subcortexmentioning

confidence: 99%

New Tests for Language Mapping with Intraoperative Electrical Stimulation of the Brain to Preserve Language in Individuals with Tumors and Epilepsy: A Preliminary Follow-Up Study

Połczyńska

2009

Poznań Studies in Contemporary Linguistics

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Intraoperative Electrical Stimulation (IES) of the brain is performed to localise and spare language functional areas before extraction of brain tissue in patients with tumors and epilepsy. The procedure is very precise and highly effective. Yet, it is argued that language tests used during IES are too limited. This article presents new language tests that have a potential of minimising post-operative risk to language function. It is a continuation of a previous study (Połczyńska 2008) and it contains extended versions of earlier presented tests, as well as new tests designed in three sets: (1) Grammar-focused tests for the dominant left hemisphere, (2) Non-dominant righthemisphere tests and (3) Tests for the subcortex. To assure maximum safety and efficiency of the tests before they are used during IES for the first time, it is suggested that they are first used with patients with intractable epilepsy who have a multielectrode subdural grid implanted onto their cortex to trace the source of seizures. The subdural grid gives a chance to carry out an electrical stimulation of those areas of the cortex which are covered with a grid. This type of language mapping is carried out in a ward and is not time-limited.

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“…1,2,12 Gliomas in areas thought to be motor eloquent based on preoperative imaging have often proven to be resectable without permanent deficits after the area in question tested negative for motor function via intraoperative mapping. 1,2,4,6,9,11,13,26,35,38 Furthermore, a proof-of-concept analysis showed that tumors adjacent to motor eloquent areas may be safely removed down to MTs as low as 1-3 mA, so long as MEP monitoring remains stable.…”

mentioning

confidence: 99%

“…mittent subcortical mapping 2,12,14,19,33,47 or continuous dynamic mapping 31 are used intraoperatively to localize the CST and thereby reduce the risk of motor deficits.…”

mentioning

confidence: 99%

Intraoperative monopolar mapping during 5-ALA–guided resections of glioblastomas adjacent to motor eloquent areas: evaluation of resection rates and neurological outcome

Schucht¹,

Seidel²,

Beck³

et al. 2014

FOC

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Object Resection of glioblastoma adjacent to motor cortex or subcortical motor pathways carries a high risk of both incomplete resection and postoperative motor deficits. Although the strategy of maximum safe resection is widely accepted, the rates of complete resection of enhancing tumor (CRET) and the exact causes for motor deficits (mechanical vs vascular) are not always known. The authors report the results of their concept of combining monopolar mapping and 5-aminolevulinic acid (5-ALA)–guided surgery in patients with glioblastoma adjacent to eloquent tissue. Methods The authors prospectively studied 72 consecutive patients who underwent 5-ALA–guided surgery for a glioblastoma adjacent to the corticospinal tract (CST; < 10 mm) with continuous dynamic monopolar motor mapping (short-train interstimulus interval 4.0 msec, pulse duration 500 μsec) coupled to an acoustic motor evoked potential (MEP) alarm. The extent of resection was determined based on early (< 48 hours) postoperative MRI findings. Motor function was assessed 1 day after surgery, at discharge, and at 3 months. Results Five patients were excluded because of nonadherence to protocol; thus, 67 patients were evaluated. The lowest motor threshold reached during individual surgery was as follows (motor threshold, number of patients): > 20 mA, n = 8; 11–20 mA, n = 13; 6–10 mA, n = 10; 4–5 mA, n = 13; and 1–3 mA, n = 23. Motor deterioration at postsurgical Day 1 and at discharge occurred in 30% (n = 20) and 10% (n = 7) of patients, respectively. At 3 months, 3 patients (4%) had a persisting postoperative motor deficit, 2 caused by vascular injury and 1 by mechanical injury. The rates of intra- and postoperative seizures were 1% and 0%, respectively. Complete resection of enhancing tumor was achieved in 73% of patients (49/67) despite proximity to the CST. Conclusions A rather high rate of CRET can be achieved in glioblastomas in motor eloquent areas via a combination of 5-ALA for tumor identification and intraoperative mapping for distinguishing between presumed and actual motor eloquent tissues. Continuous dynamic mapping was found to be a very ergonomic technique that localizes the motor tissue early and reliably.

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Usefulness of intraoperative electrical subcortical mapping during surgery for low-grade gliomas located within eloquent brain regions: functional results in a consecutive series of 103 patients

Cited by 460 publications

References 127 publications

Diffusion tensor imaging tractography and intraoperative neurophysiological monitoring in surgery of intracranial tumors located near the pyramidal tract

Diffusion tensor imaging tractography and intraoperative neurophysiological monitoring in surgery of intracranial tumors located near the pyramidal tract

New Tests for Language Mapping with Intraoperative Electrical Stimulation of the Brain to Preserve Language in Individuals with Tumors and Epilepsy: A Preliminary Follow-Up Study

Intraoperative monopolar mapping during 5-ALA–guided resections of glioblastomas adjacent to motor eloquent areas: evaluation of resection rates and neurological outcome

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