Verst S M, de Aguiar P H P, Joaquim M A S, Vieira V G, Sucena A B C, Maldaun M V C
Brain Spine Neurophysiology, Intraoperative Neurophysiology at Hospital Sirio Libanês, Rua Barão de Teffé, 1000 sala 55 Jundiai, São Paulo, SP 13208-761, Brazil.
Neurology at Catholic Pontifica University of São Paulo, Department of Internal Medicine, Rua David Ben Gurion, 1077 apto 12, São Paulo, SP 05634-001, Brazil.
Clin Neurophysiol Pract. 2018 Dec 10;4:1-8. doi: 10.1016/j.cnp.2018.11.002. eCollection 2019.
To determine whether high-frequency 250-500 Hz monopolar stimulation is effective for mapping cortical and subcortical language structures during brain tumor resection.
Using high-frequency monopolar stimulation, we mapped the speech areas of 41 awake patients undergoing brain tumor resection in the dominant hemisphere, subject to risk of lesions in the cortical and subcortical speech tracts. Patients were tested for object naming, semantic and other language tasks.
Mapping was positive in 22 out of 41 patients. Nine patients presented clinical worsening immediately after surgery. Only one patient did not recover after the 30-day follow-up. Nineteen patients showed negative mapping for language tracts, none of whom exhibited worsening of symptoms at the final evaluation. The applied method showed 89% sensitivity and 56% specificity rates.
The applied method was effective in identifying cortical and subcortical speech areas during the surgical resection of brain tumors.
Determining whether monopolar high-frequency stimulation is effective for language mapping is important, since it may be very effective in infiltrating tumor areas and nearby edema region.
确定高频250 - 500赫兹单极刺激在脑肿瘤切除术中对绘制皮质和皮质下语言结构是否有效。
我们使用高频单极刺激，对41例在优势半球接受脑肿瘤切除的清醒患者的语言区域进行了绘制，这些患者存在皮质和皮质下语言通路受损的风险。对患者进行了物体命名、语义及其他语言任务测试。
41例患者中有22例绘制结果为阳性。9例患者术后立即出现临床症状恶化。30天随访后只有1例患者未恢复。19例患者语言通路绘制结果为阴性，其中无一例在最终评估时出现症状恶化。所应用的方法显示出89%的灵敏度和56%的特异度。
所应用的方法在脑肿瘤手术切除过程中对识别皮质和皮质下语言区域有效。
确定单极高频刺激对语言映射是否有效很重要，因为它在浸润肿瘤区域和附近水肿区域可能非常有效。
