Department of Neurological Surgery, University of California-San Francisco, San Francisco, California 94143-0628, USA.
Neurosurgery. 2012 Nov;71(5):1012-22. doi: 10.1227/NEU.0b013e31826d2b78.
The removal of brain tumors in perieloquent or eloquent cortex risks causing new neurological deficits in patients. The assessment of the functionality of perilesional tissue is essential to avoid postoperative neurological morbidity.
To evaluate preoperative magnetoencephalography-based functional connectivity as a predictor of short- and medium-term neurological outcome after removal of gliomas in perieloquent and eloquent areas.
Resting-state whole-brain magnetoencephalography recordings were obtained from 79 consecutive subjects with focal brain gliomas near or within motor, sensory, or language areas. Neural activity was estimated using adaptive spatial filtering. The mean imaginary coherence between voxels in and around brain tumors was compared with contralesional voxels and used as an index of their functional connectivity with the rest of the brain. The connectivity values of the tissue resected during surgery were correlated with the early (1 week postoperatively) and medium-term (6 months postoperatively) neurological morbidity.
Patients undergoing resection of tumors with decreased functional connectivity had a 29% rate of a new neurological deficit 1 week after surgery and a 0% rate at 6-month follow-up. Patients undergoing resection of tumors with increased functional connectivity had a 60% rate of a new deficit at 1 week and a 25% rate at 6 months.
Magnetoencephalography connectivity analysis gives a valuable preoperative evaluation of the functionality of the tissue surrounding tumors in perieloquent and eloquent areas. These data may be used to optimize preoperative patient counseling and surgical strategy.
在语言区或运动区附近切除脑瘤可能会导致患者出现新的神经功能缺损。评估瘤周组织的功能对于避免术后神经发病率至关重要。
评估基于脑磁图的功能连接术前作为预测语言区或运动区附近脑胶质瘤切除术后短期和中期神经功能预后的指标。
对 79 例大脑局灶性胶质瘤患者进行了静息态全脑脑磁图记录，这些患者的肿瘤位于或接近运动、感觉或语言区。使用自适应空间滤波估计神经活动。肿瘤内和周围体素之间的平均虚相干与对侧体素进行比较，并用作与大脑其他部位功能连接的指标。术中切除组织的连接值与早期（术后 1 周）和中期（术后 6 个月）神经发病率相关。
切除功能连接降低的肿瘤的患者术后 1 周新出现神经功能缺损的发生率为 29%，6 个月随访时为 0%。切除功能连接增加的肿瘤的患者术后 1 周新出现缺陷的发生率为 60%，6 个月时为 25%。
脑磁图连接分析可对语言区或运动区附近肿瘤周围组织的功能进行有价值的术前评估。这些数据可用于优化术前患者咨询和手术策略。
