Intraoperative subcortico-cortical evoked potentials of the visual pathway under general anesthesia

Boëx, Colette; Goga, Cristina; Bérard, Nadia; Awadhi, Abdullah Al; Bartoli, Andréa; Meling, Torstein R.; Bijlenga, Philippe; Schaller, Karl

doi:10.1016/j.clinph.2021.02.399

Cited by 8 publications

(5 citation statements)

References 37 publications

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“…Although there were initial waveform variations among their patients, these waveforms remained stable throughout the procedures and exhibited changes that aligned with postoperative visual function, highlighting the potential utility of intraoperative cortical VEP monitoring for assessing the functional integrity of the posterior visual pathway. In 2021, Boëx et al correlated the latency of the waveforms to the velocity of signal propagation along the optic pathway [9]. They could not demonstrate, however, a rule of thumb to correlate the stimulation intensity to the distance to the optic radiation (similarly to the motor mapping) [26,27].…”

Section: Discussionmentioning

confidence: 99%

“…Studies in awake craniotomies demonstrate that direct monitoring of the VF of the patients can prevent hemianopia [4][5][6][7]. In recent years, the integration of real-time intraoperative monitoring of VEPs in brain tumour surgery has shown promising results [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

“…Ota et al (2010) demonstrated reliable detection of visual responses via a direct cortical recording in a small population of patients that underwent epilepsy surgery under general anaesthesia [20]. Eleven years later, Boëx et al showed in a mixed population of neurooncology and neuro-vascular patients that subcortico-cortical evoked potentials can be observed in the optic radiation and Meyer's loop [9]. They correlated the latency of the waveforms to the velocity of signal propagation along the optic pathway.…”

Section: Introductionmentioning

confidence: 99%

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Intraoperative Neuromonitoring of the Visual Pathway in Asleep Neuro-Oncology Surgery

Soumpasis

Díaz-Baamonde

Ghimire

et al. 2023

Cancers

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Brain tumour surgery in visual eloquent areas poses significant challenges to neurosurgeons and has reported inconsistent results. This is a single-centre prospective cohort study of patients admitted for asleep surgery of intra-axial lesions in visual eloquent areas. Demographic and clinical information, data from tractography and visual evoked potentials (VEPs) monitoring were recorded and correlated with visual outcomes. Thirty-nine patients were included (20 females, 19 males; mean age 52.51 ± 14.08 years). Diffuse intrinsic glioma was noted in 61.54% of patients. There was even distribution between the temporal, occipital and parietal lobes, while 55.26% were right hemispheric lesions. Postoperatively, 74.4% remained stable in terms of visual function, 23.1% deteriorated and 2.6% improved. The tumour infiltration of the optic radiation on tractography was significantly related to the visual field deficit after surgery (p = 0.016). Higher N75 (p = 0.036) and P100 (p = 0.023) amplitudes at closure on direct cortical VEP recordings were associated with no new postoperative visual deficit. A threshold of 40% deterioration of the N75 (p = 0.035) and P100 (p = 0.020) amplitudes correlated with a risk of visual field deterioration. To conclude, direct cortical VEP recordings demonstrated a strong correlation with visual outcomes, contrary to transcranial recordings. Invasion of the optic radiation is related to worse visual field outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Intraoperative Neuromonitoring of the Visual Pathway in Asleep Neuro-Oncology Surgery

Soumpasis

Díaz-Baamonde

Ghimire

et al. 2023

Cancers

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“…Total intravenous anesthesia was used in 7 articles (16,17,19,31,36,38,39), inhalational anesthetic in 2 reports (33,35), and both techniques in 1 paper (37). The remaining 3 papers did not report the type of anesthesia used (30,32,34).…”

Section: Capi Task For Intraoperative Visual Mappingmentioning

confidence: 99%

Visual Mapping for Tumor Resection: A Proof of Concept of a New Intraoperative Task and A Systematic Review of the Literature

et al. 2022

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“…During the past two decades, US has been widely used for intraoperative guidance and resection control in glioma surgery [ 10 , 11 , 12 , 13 , 14 , 15 ], in part due to its capacity to be complementary to other intraoperative techniques like 5-Aminolevulinic acid (5-ALA) fluorescence [ 16 ], intraoperative magnetic resonance imaging (MRI) [ 17 ], awake mapping [ 18 , 19 , 20 ] and asleep neuromonitoring [ 21 , 22 , 23 ].…”

Section: Introductionmentioning

confidence: 99%

From Focused Ultrasound Tumor Ablation to Brain Blood Barrier Opening for High Grade Glioma: A Systematic Review

Paun

Moiraghi

Jannelli

et al. 2021

Cancers

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Background: Focused Ultrasound (FUS) is gaining a therapeutic role in neuro-oncology considering its novelty and non-invasiveness. Multiple pre-clinical studies show the efficacy of FUS mediated ablation and Blood-Brain Barrier (BBB) opening in high-grade glioma (HGG), but there is still poor evidence in humans, mainly aimed towards assessing FUS safety. Methods: With this systematic review our aim is, firstly, to summarize how FUS is proposed for human HGG treatment. Secondly, we focus on future perspectives and new therapeutic options. Using PRISMA 2020 guidelines, we reviewed case series and trials with description of patient characteristics, pre- and post-operative treatments and FUS outcomes. We considered nine case series (five about tumor ablation and four about BBB opening) with FUS-treated HGG patients between 1991 and 2021. Results: Sixty-eight patients were considered in total, mostly males (67.6%), with a mean age of 50.5 ± 15.3 years old. Major complication rates were found in the tumor ablation group (26.1%). FUS has been rarely applied for direct tumoral ablation in human HGG patients with controversial results, but at the best of current studies, FUS-mediated BBB opening is showing good results with very low complication rates, paving the way for a new reliable technique to improve local chemotherapy delivery and antitumoral immune response. Conclusions: FUS can become a complementary technique to surgical resection and standard radiochemotherapy in recurrent HGG. Ongoing trials could provide in the near future more data on FUS-mediated BBB opening impact on progression-free survival, overall survival and potential drug-delivery capacities.

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Intraoperative subcortico-cortical evoked potentials of the visual pathway under general anesthesia

Cited by 8 publications

References 37 publications

Intraoperative Neuromonitoring of the Visual Pathway in Asleep Neuro-Oncology Surgery

Intraoperative Neuromonitoring of the Visual Pathway in Asleep Neuro-Oncology Surgery

Visual Mapping for Tumor Resection: A Proof of Concept of a New Intraoperative Task and A Systematic Review of the Literature

From Focused Ultrasound Tumor Ablation to Brain Blood Barrier Opening for High Grade Glioma: A Systematic Review

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