Kombos Theodoros, Picht Thomas, Suess Olaf
Department of Neurosurgery, Charité--Universitätsmedizin Berlin, Berlin, Germany.
J Clin Neurophysiol. 2008 Dec;25(6):340-5. doi: 10.1097/WNP.0b013e31818f4fd8.
The angular gyrus (AG) is a circumscribed area between the parietal and temporal lobes and its exact function is not clear. The purpose of the present study was to investigate the feasibility of intraoperative electrical stimulation of the AG in humans. The AG was electrically stimulated in five cases with the assistance of neuronavigation. Two different stimulation techniques were applied: bipolar cortical stimulation and monopolar cortical stimulation. After monopolar cortical stimulation, a compound muscle action potential was recorded from the contralateral arm muscles in three patients. In the remaining two patients no compound muscle action potential was elicited after monopolar cortical stimulation. The latency of the recorded compound muscle action potential from the thenar muscle ranged from 30.3 to 32.7 milliseconds and from the two forearm flexors was 28.7 and 29.7. Bipolar stimulation generated a motor response in the contralateral extremity in three research subjects but no motor response in two. Response was obtained in all three research subjects with the combination of 40 Hz and a duration of 4 or 6 seconds. Because this is to their knowledge the first report demonstrating a functional output of Exner's area to the motor cortex, it would be difficult to suggest all the pathways and functions of this complex connectivity. The aim of the pilot study presented here was to investigate the feasibility of electrical stimulation of the AG. The findings presented here show that intraoperative electrical stimulation of the AG is possible. Although the results are limited by the small number of patients investigated, they are encouraging and suggest that it is worthwhile to continue research in this area.
角回（AG）是顶叶和颞叶之间的一个限定区域，其确切功能尚不清楚。本研究的目的是探讨在人体中对角回进行术中电刺激的可行性。在神经导航的辅助下，对5例患者的角回进行了电刺激。应用了两种不同的刺激技术：双极皮层刺激和单极皮层刺激。在单极皮层刺激后，3例患者对侧手臂肌肉记录到复合肌肉动作电位。其余2例患者在单极皮层刺激后未引出复合肌肉动作电位。从大鱼际肌记录到的复合肌肉动作电位潜伏期为30.3至32.7毫秒，从两块前臂屈肌记录到的潜伏期分别为28.7和29.7毫秒。双极刺激在3例研究对象的对侧肢体产生了运动反应，但2例未产生运动反应。在所有3例研究对象中，40赫兹与4或6秒的持续时间相结合时均获得了反应。由于据他们所知，这是第一份证明埃克斯纳区向运动皮层有功能输出的报告，因此很难提出这种复杂连接的所有通路和功能。本文提出的初步研究目的是探讨对角回进行电刺激的可行性。这里呈现的结果表明，对角回进行术中电刺激是可行的。尽管结果受所研究患者数量较少的限制，但它们令人鼓舞，并表明在该领域继续研究是值得的。
