Electrophysiological Mapping During Brain Tumor Surgery: Recording Cortical Potentials Evoked Locally, Subcortically and Remotely by Electrical Stimulation to Assess the Brain Connectivity On-line.

Autor: Boyer A; CAMIN, INRIA, LIRMM, Université de Montpellier, 34090, Montpellier, France., Ramdani S; IDH, LIRMM, Université de Montpellier, 34095, Montpellier, France., Duffau H; 'Plasticité cérébrale, cellules souches neurales et tumeurs gliales', INSERM U1051, Institut des Neurosciences de Montpellier, 34295, Montpellier, France.; Département de Neurochirurgie, Centre Hospitalier Régional Universitaire de Montpellier Gui de Chauliac, 34295, Montpellier, France., Dali M; Département de Neurochirurgie, Hopital Lariboisière, Paris, France., Vincent MA; CAMIN, INRIA, LIRMM, Université de Montpellier, 34090, Montpellier, France.; SCALab - Sciences Cognitives et Sciences Affectives, CNRS, UMR 9193, Université de Lille, 59000, Lille, France., Mandonnet E; Département de Neurochirurgie, Hopital Lariboisière, Paris, France., Guiraud D; CAMIN, INRIA, LIRMM, Université de Montpellier, 34090, Montpellier, France., Bonnetblanc F; CAMIN, INRIA, LIRMM, Université de Montpellier, 34090, Montpellier, France. francois.bonnetblanc@inria.fr.; Institut Universitaire de France, 75231, Paris, France. francois.bonnetblanc@inria.fr.; 'Cognition, Action et Plasticité Sensorimotrice', INSERM U1093, UFR STAPS, Université Bourgogne Franche-Comté, 21078, Dijon, France. francois.bonnetblanc@inria.fr.
Jazyk: angličtina
Zdroj: Brain topography [Brain Topogr] 2021 Mar; Vol. 34 (2), pp. 221-233. Date of Electronic Publication: 2021 Jan 05.
DOI: 10.1007/s10548-020-00814-0
Abstrakt: Direct electrical stimulation (DES) is used to perform functional brain mapping during awake surgery and in epileptic patients. DES may be coupled with the measurement of Evoked Potentials (EP) to study the conductive and integrative properties of activated neural ensembles and probe the spatiotemporal dynamics of short- and long-range networks. However, its electrophysiological effects remain by far unknown. We recorded ECoG signals on two patients undergoing awake brain surgery and measured EP on functional sites after cortical stimulations and were the firsts to record three different types of EP on the same patients. Using low-intensity (1-3 mA) to evoke electrogenesis we observed that: (i) "true" remote EPs are attenuated in amplitude and delayed in time due to the divergence of white matter pathways; (ii) "false" remote EPs are attenuated but not delayed: as they originate from the same electrical source; (iii) Singular but reproducible positive components in the EP can be generated when the DES is applied in the temporal lobe or the premotor cortex; and (iv) rare EP can be triggered when the DES is applied subcortically: these can be either negative, or surprisingly, positive. We proposed different activation and electrophysiological propagation mechanisms following DES, based on the nature of activated neural elements and discussed important methodological pitfalls when measuring EP in the brain. Altogether, these results pave the way to map the connectivity in real-time between the DES and the recording sites; to characterize the local electrophysiological states and to link electrophysiology and function. In the future, and in practice, this technique could be used to perform electrophysiological mapping in order to link (non)-functional to electrophysiological responses with DES and could be used to guide the surgical act itself.
Databáze: MEDLINE
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