Sollmann Nico, Bulubas Lucia, Tanigawa Noriko, Zimmer Claus, Meyer Bernhard, Krieg Sandro M
Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
BMC Neurosci. 2017 Jan 3;18(1):5. doi: 10.1186/s12868-016-0321-4.
Recording of motor evoked potentials (MEPs) is used during navigated transcranial magnetic stimulation (nTMS) motor mapping to locate motor function in the human brain. However, factors potentially underlying MEP latency variability in neurosurgical motor mapping are vastly unknown. In the context of this study, one hundred brain tumor patients underwent preoperative nTMS-based motor mapping of the tumor hemisphere between 2010 and 2013. Fourteen predefined predictor variables were recorded, and MEP latencies of abductor pollicis brevis muscle (APB), abductor digiti minimi muscle (ADM), and flexor carpi radialis muscle (FCR) were analyzed using linear mixed-effect multiple regression analysis with the forward step-wise model comparison approach.
Common factors (relevant to APB, ADM, and FCR) for MEP latency variability were gender, most likely due to body height, and antiepileptic drug (AED) intake. Muscle-specific factors (relevant to APB, ADM, or FCR) for MEP latency variability were resting motor threshold (rMT), tumor side, and tumor location.
Based on a large cohort of neurosurgical patients, this study provides data on a wide range of clinical factors that may underlie MEP latency variability. The factors that significantly contributed to MEP latency variability should be standardly recorded and taken into consideration during neurosurgical motor mapping.
在导航经颅磁刺激（nTMS）运动功能映射过程中，运动诱发电位（MEP）记录用于定位人脑的运动功能。然而，神经外科手术运动功能映射中MEP潜伏期变异性的潜在因素却鲜为人知。在本研究中，2010年至2013年期间，100例脑肿瘤患者在术前对肿瘤半球进行了基于nTMS的运动功能映射。记录了14个预先定义的预测变量，并使用向前逐步模型比较方法，通过线性混合效应多元回归分析对拇短展肌（APB）、小指展肌（ADM）和桡侧腕屈肌（FCR）的MEP潜伏期进行了分析。
MEP潜伏期变异性的常见因素（与APB、ADM和FCR相关）是性别，最可能原因是身高，以及抗癫痫药物（AED）的摄入。MEP潜伏期变异性的肌肉特异性因素（与APB、ADM或FCR相关）是静息运动阈值（rMT）、肿瘤侧别和肿瘤位置。
基于大量神经外科患者队列，本研究提供了一系列可能是MEP潜伏期变异性基础的临床因素的数据。在神经外科手术运动功能映射过程中，应常规记录并考虑对MEP潜伏期变异性有显著影响的因素。
