Surgical treatment of eloquent brain area tumors using neurophysiological mapping of the speech and motor areas and conduction tracts

Зуев, А. А.; Korotchenko, E N; Багишева, Н.В.; Pedyash, N V; Teplykh, Boris

doi:10.17116/neiro201780739-50

Cited by 7 publications

(1 citation statement)

References 15 publications

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“…It is a valuable technique for monitoring the function of the nervous system in at-risk conditions, including the surgical operation of deficits in neurological function or physiological changes in the internal environment [ 8 ]. Most transient injuries to the nerve, such as prolonged retraction, excessive electrocoagulation and obstructed blood circulation, are easily corrected during surgery [ 11 , 12 ]. By understanding the changes in electrophysiological signals in the process of nerve transmission, surgeons can judge the integrity of neurological function in a timely and comprehensive manner, improve the quality of decision-making and ultimately reduce the rate of surgical disability [ 13 , 14 ]].…”

Section: Introductionmentioning

confidence: 99%

Application value of intraoperative electrophysiological monitoring in cerebral eloquent area glioma surgery: a retrospective cohort study

Liu,

Zhao,

Huang

et al. 2024

Discov Onc

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Introduction Surgery for gliomas involving eloquent areas is a very challenging microsurgical procedure. Maximizing both the extent of resection (EOR) and preservation of neurological function have always been the focus of attention. Intraoperative neurophysiological monitoring (IONM) is widely used in this kind of surgery. The purpose of this study was to evaluate the efficacy of IONM in eloquent area glioma surgery. Methods Sixty-eight glioma patients who underwent surgical treatment from 2014 to 2019 were included in this retrospective cohort study, which focused on eloquent areas. Clinical indicators and IONM data were analysed preoperatively, two weeks after surgery, and at the final follow-up. Logistic regression, Cox regression, and Kaplan‒Meier analyses were performed, and nomograms were then established for predicting prognosis. The diagnostic value of the IONM indicator was evaluated by the receiver operating characteristic (ROC) curve. Results IONM had no effect on the postoperative outcomes, including EOR, intraoperative bleeding volume, duration of surgery, length of hospital stay, and neurological function status. However, at the three-month follow-up, the percentage of patients who had deteriorated function in the monitored group was significantly lower than that in the unmonitored group (23.3% vs. 52.6%; P < 0.05). Logistic regression analysis showed that IONM was a significant factor in long-term neurological function (OR = 0.23, 95% CI (0.07–0.70). In the survival analysis, long-term neurological deterioration indicated worsened overall survival (OS) and progression-free survival (PFS). A prognostic nomogram was established through Cox regression model analysis, which could predict the probability 3-year survival rate. The concordance index was 0.761 (95% CI 0.734–0.788). The sensitivity and specificity of IONM evoked potential (SSEP and TCeMEP) were 0.875 and 0.909, respectively. In the ROC curve analysis, the area under the curve (AUC) for the SSEP and TCeMEP curves was 0.892 (P < 0.05). Conclusions The application of IONM could improve long-term neurological function, which is closely related to prognosis and can be used as an independent prognostic factor. IONM is practical and widely available for predicting postoperative functional deficits in patients with eloquent area glioma.

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Section: Introductionmentioning

confidence: 99%

Application value of intraoperative electrophysiological monitoring in cerebral eloquent area glioma surgery: a retrospective cohort study

Liu,

Zhao,

Huang

et al. 2024

Discov Onc

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Clinical Pearls and Methods for Intraoperative Motor Mapping

et al. 2021

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Resection of brain tumors involving motor areas and pathways requires the identification and preservation of various cortical and subcortical structures involved in motor control at the time of the procedure, in order to maintain the patient's full motor capacities. The use of brain mapping techniques has now been integrated into clinical practice for many years, as they help the surgeon to identify the neural structures involved in motor functions. A common definition of motor function, as well as knowledge of its neural organization, has been continuously evolving, underlining the need for implementing intraoperative strategies at the time of the procedure. Similarly, mapping strategies have been subjected to continuous changes, enhancing the likelihood of preservation of full motor capacities. As a general rule, the motor mapping strategy should be as flexible as possible and adapted strictly to the individual patient and clinical context of the tumor. In this work, we present an overview of current knowledge of motor organization, indications for motor mapping, available motor mapping, and monitoring strategies, as well as their advantages and limitations. The use of motor mapping improves resection and outcomes in patients harboring tumors involving motor areas and pathways, and should be considered the gold standard in the resection of this type of tumor.

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Surgical treatment of glial tumors of the paralimbic system

Dimertsev¹,

Зуев²

2022

Vopr. neirokhir.

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Surgical treatment of eloquent brain area tumors using neurophysiological mapping of the speech and motor areas and conduction tracts

Abstract: Resection of eloquent brain area tumors using intraoperative neurophysiological monitoring enables complete resection of the tumor at a low risk of persistent neurological deficits, which ultimately improves the patient's life prognosis.

Cited by 7 publications

References 15 publications

Application value of intraoperative electrophysiological monitoring in cerebral eloquent area glioma surgery: a retrospective cohort study

Application value of intraoperative electrophysiological monitoring in cerebral eloquent area glioma surgery: a retrospective cohort study

Clinical Pearls and Methods for Intraoperative Motor Mapping

Surgical treatment of glial tumors of the paralimbic system

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