Cortico-cortical evoked potentials of language tracts in minimally invasive glioma surgery guided by Penfield stimulation

组织病理学 神经生理学 胶质瘤 失语症 医学 诱发电位 刺激 外科 弓状束 放射科 听力学 病理 解剖 磁共振成像 精神科 纤维束成像 内科学 白质 癌症研究
作者
Kathleen Seidel,Jonathan Wermelinger,Pablo Alvarez-Abut,Vedran Deletis,Andreas Raabe,David Zhang,Philippe Schucht
出处
期刊:Clinical Neurophysiology [Elsevier BV]
被引量:1
标识
DOI:10.1016/j.clinph.2023.12.136
摘要

We investigated the feasibility of recording cortico-cortical evoked potentials (CCEPs) in patients with low- and high-grade glioma. We compared CCEPs during awake and asleep surgery, as well as those stimulated from the functional Broca area and recorded from the functional Wernicke area (BtW), and vice versa (WtB). We also analyzed CCEP properties according to tumor location, histopathology, and aphasia. We included 20 patients who underwent minimally invasive surgery in an asleep-awake-asleep setting. Strip electrode placement was guided by classical Penfield stimulation of positive language sites and fiber tracking of the arcuate fascicle. CCEPs were elicited with alternating monophasic single pulses of 1.1 Hz frequency and recorded as averaged signals. Intraoperatively, there was no post-processing of the signal. Ninety-seven CCEPs from 19 patients were analyzed. There was no significant difference in CCEP properties when comparing awake versus asleep, nor BtW versus WtB. CCEP amplitude and latency were affected by tumor location and histopathology. CCEP features after tumor resection correlated with short- and long-term postoperative aphasia. CCEP recordings are feasible during minimally invasive surgery. CCEPs might be surrogate markers for altered connectivity of the language tracts. This study may guide the incorporation of CCEPs into intraoperative neurophysiological monitoring.
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