de Jongh A, Baayen J C, de Munck J C, Heethaar R M, Vandertop W P, Stam C J
Department of Clinical Physics, MEG Center, VU University Medical Center, Amsterdam, The Netherlands.
Neuroimage. 2003 Dec;20(4):2291-301. doi: 10.1016/j.neuroimage.2003.07.030.
The goal of the MEG study was to investigate the influence of tumor treatment on pathological delta activity (1-4 Hz). The treatment consisted of neurosurgery, and in some of the patients, additional radiotherapy. MEG and MR recordings were made both before and after the treatment in 17 patients. The signal power in the delta frequency band was determined for each recording. The malignant tumors were associated with large tumor volumes. Furthermore, both malignant tumors and tumor volume were associated with high signal powers in the delta band, indicating a correlation of delta power with the severity of the lesions. In all patients with high grade tumors, the delta power was lower after the treatment. The sources underlying the delta signals were estimated with an automatic single dipole analysis method. Estimated sources were projected onto MR scans. Preoperatively 14 clusters of equivalent sources describing focal activity were found in 12 out of 17 patients. Thirteen of these clusters were located near the tumor, and one cluster near an edema border. The locations near tumors are plausible and suggest that in general the source estimation was reliable. After the operation, 13 such clusters were found in 12 patients. Eleven clusters were located near the lesion border and one cluster near the edema border. Furthermore a cluster contralateral to the lesion in the other hemisphere indicated that brain lesions can affect the functioning of more distant brain areas than just the peritumoral brain tissue. Of the 12 patients who had preoperatively peritumoral clusters, 11 patients had postoperatively perilesional sources. In these cases the shift in source locations was in general considerably smaller than the dimension of the preoperative tumors. This finding indicates that similar areas generate the pre- and postoperative delta activity. Furthermore, focal delta sources were found in a case without tumor recurrence, and also in cases that most tumor tissue was removed. These findings suggest that the pathology underlying the slow waves is not the presence of the tumor bulk but the structural damage done by the tumors on the surrounding white/gray matter.
脑磁图(MEG)研究的目的是调查肿瘤治疗对病理性δ活动(1 - 4赫兹)的影响。治疗包括神经外科手术,部分患者还接受了额外的放射治疗。对17例患者在治疗前后均进行了脑磁图和磁共振成像(MR)记录。对每次记录确定δ频段的信号功率。恶性肿瘤与大的肿瘤体积相关。此外,恶性肿瘤和肿瘤体积均与δ频段的高信号功率相关,表明δ功率与病变严重程度相关。在所有高级别肿瘤患者中,治疗后δ功率降低。采用自动单偶极分析方法估计δ信号的来源。将估计的来源投射到磁共振扫描上。术前,17例患者中有12例发现了14个描述局灶性活动的等效源簇。其中13个簇位于肿瘤附近,1个簇位于水肿边界附近。肿瘤附近的位置是合理的,表明总体上源估计是可靠的。术后,12例患者中发现了13个这样的簇。11个簇位于病变边界附近,1个簇位于水肿边界附近。此外,在另一侧半球病变对侧的一个簇表明,脑病变可影响比肿瘤周围脑组织更远的脑区功能。在术前有肿瘤周围簇的12例患者中,11例术后有病变周围源。在这些病例中,源位置的变化通常比术前肿瘤的尺寸小得多。这一发现表明术前和术后产生δ活动的区域相似。此外,在无肿瘤复发的病例以及大部分肿瘤组织已被切除的病例中也发现了局灶性δ源。这些发现表明,慢波的病理基础不是肿瘤块的存在,而是肿瘤对周围白质/灰质造成的结构损伤。