Intraoperative electrocorticography for physiological research in movement disorders: principles and experience in 200 cases
| Autor: | Fedor Panov, Jill L. Ostrem, Nicole C. Swann, Emily Levin, Svjetlana Miocinovic, Salman E. Qasim, Philip A. Starr, Coralie de Hemptinne |
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| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Movement disorders Intraoperative Neurophysiological Monitoring FDA = Food and Drug Administration Parkinson's disease Deep Brain Stimulation medicine.medical_treatment Neurodegenerative Postoperative Complications 0302 clinical medicine 80 and over Electrocorticography Aged 80 and over Cerebral Cortex Assistive Technology education.field_of_study primary motor cortex Movement Disorders medicine.diagnostic_test Rehabilitation DLPFC = dorsolateral prefrontal cortex General Medicine Middle Aged LFP = local field potential DBS = deep brain stimulation Treatment Outcome Anesthesia Neurological Neurosurgery medicine.symptom Primary motor cortex Adult medicine.medical_specialty Deep brain stimulation brain oscillations Clinical Sciences Population Bioengineering Article Young Adult 03 medical and health sciences Hematoma medicine Humans PAC = phase-amplitude coupling education functional neurosurgery electrocorticography Aged Epilepsy Neurology & Neurosurgery business.industry Neurosciences medicine.disease Brain Disorders MER = microelectrode recording 030104 developmental biology ECoG = electrocorticography Somatosensory evoked potential business 030217 neurology & neurosurgery |
| Zdroj: | Journal of neurosurgery, vol 126, iss 1 Panov, F; Levin, E; de Hemptinne, C; Swann, NC; Qasim, S; Miocinovic, S; et al.(2017). Intraoperative electrocorticography for physiological research in movement disorders: principles and experience in 200 cases. JOURNAL OF NEUROSURGERY, 126(1), 122-131. doi: 10.3171/2015.11.JNS151341. UC San Francisco: Retrieved from: http://www.escholarship.org/uc/item/55m986bp |
| ISSN: | 1933-0693 0022-3085 |
| DOI: | 10.3171/2015.11.jns151341 |
| Popis: | OBJECTIVE Contemporary theories of the pathophysiology of movement disorders emphasize abnormal oscillatory activity in basal ganglia-thalamocortical loops, but these have been studied in humans mainly using depth recordings. Recording from the surface of the cortex using electrocorticography (ECoG) provides a much higher amplitude signal than depth recordings, is less susceptible to deep brain stimulation (DBS) artifacts, and yields a surrogate measure of population spiking via “broadband gamma” (50–200 Hz) activity. Therefore, a technical approach to movement disorders surgery was developed that employs intraoperative ECoG as a research tool. METHODS One hundred eighty-eight patients undergoing DBS for the treatment of movement disorders were studied under an institutional review board–approved protocol. Through the standard bur hole exposure that is clinically indicated for DBS lead insertion, a strip electrode (6 or 28 contacts) was inserted to cover the primary motor or prefrontal cortical areas. Localization was confirmed by the reversal of the somatosensory evoked potential and intraoperative CT or 2D fluoroscopy. The ECoG potentials were recorded at rest and during a variety of tasks and analyzed offline in the frequency domain, focusing on activity between 3 and 200 Hz. Strips were removed prior to closure. Postoperative MRI was inspected for edema, signal change, or hematoma that could be related to the placement of the ECoG strip. RESULTS One hundred ninety-eight (99%) strips were successfully placed. Two ECoG placements were aborted due to resistance during the attempted passage of the electrode. Perioperative surgical complications occurred in 8 patients, including 5 hardware infections, 1 delayed chronic subdural hematoma requiring evacuation, 1 intraparenchymal hematoma, and 1 venous infarction distant from the site of the recording. None of these appeared to be directly related to the use of ECoG. CONCLUSIONS Intraoperative ECoG has long been used in neurosurgery for functional mapping and localization of seizure foci. As applied during DBS surgery, it has become an important research tool for understanding the brain networks in movement disorders and the mechanisms of therapeutic stimulation. In experienced hands, the technique appears to add minimal risk to surgery. |
| Databáze: | OpenAIRE |
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