Neurophysiological basis of direct cortical stimulation and applied neuroanatomy of the motor cortex: a review

Abstract

<jats:p>Intraoperative electrical stimulation of the motor cortex is a sensitive method for intraoperative mapping and monitoring of this region. Two different stimulation techniques have been established, the bipolar and monopolar techniques. Controversy exists regarding the most suitable method. Both methods have advantages and disadvantages and different electrophysiological backgrounds. The present study is a review of the electrophysiological basis of direct cortical electrical stimulation of the motor cortex. Both methods are discussed and their field of application is presented.</jats:p>

Rolandic area meningioma resection controlled and guided by intraoperative cortical mapping

“…As previously reported in baboons, the initial segment of pyramidal cells is located approximately 1.3 mm under the cortical surface. Monopolar anodic stimulation is most effective in depolarisation of the pyramidal cell zone of the cortex both in baboons and proved in humans [18,24,31]. The primary structures that are depolarised are the cell body and the initial part of the axon [6,15,31].…”

Flujometría por difusión termal para la medida del flujo sanguíneo cerebral regional en la cirugía de los aneurismas cerebrales

“…La monitorización electrofisiológica podría ser adecuada y útil para detectar la isquemia cerebral 1,18,21,29,31,33,34 , aunque ésta puede tener la desventaja del retraso en detectar cambios patológicos 4,21 , insuficiente sensibilidad en detectar isquemia subcortical 14 y limitaciones anatómicas 21,31 . Aún así la monitorización neurofisiológica constituye una herramienta altamente útil durante la cirugía aneurismática y otras indicaciones de cirugía intracraneal, por lo que nosotros la hemos incluimos en nuestro protocolo.…”

Intraoperatives elektrophysiologisches Monitoring mit evozierten Potenzialen

“…Mithilfe von MEP, die über eine Stimulationssonde direkt kortikal evoziert werden, kann ein Mapping des motorischen Kortex erfolgen. So können das primäre sensorische und das motorische Areal abgegrenzt und vor einer chirurgischen Manipulation bewahrt werden [63].…”