OBJECT: The treatment of insular tumors is controversial. Surgical treatment is associated with a higher morbidity rate than other therapies. The present work presents a new method in which the descending motor pathways are monitored during surgery for insular tumors. METHODS: Intraoperative monitoring was performed in a combination of 2 techniques. The motor cortex was stimulated with a transcranial electrical stimulus. In addition, direct subcortical stimulation was performed with an electrical anodal monopolar stimulus. Compound motor action potentials (CMAPs) were recorded from target muscles. RESULTS: Fifteen patients were included in this preliminary study. Following transcranial stimulation, CMAPs were recorded in all cases. Subcortical stimulation was successful in 12 cases. Significant CMAP alterations were recorded in 5 patients. There were no false-negative results in the series. CONCLUSIONS: The technique presented here is a safe method. It allows a quantitative monitoring of motor function and functional mapping of the pyramidal tract during insular surgery.
OBJECT: The treatment of insular tumors is controversial. Surgical treatment is associated with a higher morbidity rate than other therapies. The present work presents a new method in which the descending motor pathways are monitored during surgery for insular tumors. METHODS: Intraoperative monitoring was performed in a combination of 2 techniques. The motor cortex was stimulated with a transcranial electrical stimulus. In addition, direct subcortical stimulation was performed with an electrical anodal monopolar stimulus. Compound motor action potentials (CMAPs) were recorded from target muscles. RESULTS: Fifteen patients were included in this preliminary study. Following transcranial stimulation, CMAPs were recorded in all cases. Subcortical stimulation was successful in 12 cases. Significant CMAP alterations were recorded in 5 patients. There were no false-negative results in the series. CONCLUSIONS: The technique presented here is a safe method. It allows a quantitative monitoring of motor function and functional mapping of the pyramidal tract during insular surgery.
Authors: Carolin Weiss; Irada Tursunova; Volker Neuschmelting; Hannah Lockau; Charlotte Nettekoven; Ana-Maria Oros-Peusquens; Gabriele Stoffels; Anne K Rehme; Andrea Maria Faymonville; N Jon Shah; Karl Josef Langen; Roland Goldbrunner; Christian Grefkes Journal: Neuroimage Clin Date: 2015-01-20 Impact factor: 4.881
Authors: Carolin Weiss Lucas; Irada Tursunova; Volker Neuschmelting; Charlotte Nettekoven; Ana-Maria Oros-Peusquens; Gabriele Stoffels; Andrea Maria Faymonville; Shah N Jon; Karl Josef Langen; Hannah Lockau; Roland Goldbrunner; Christian Grefkes Journal: Neuroimage Clin Date: 2016-11-23 Impact factor: 4.881