BACKGROUND: Gliomas are often in close proximity to functional regions of the brain; therefore, electrocortical stimulation (ECS) mapping is a common technique utilized during glioma resection to identify functional areas. Stimulation-induced seizure (SIS) remains the most common reason for aborted procedures. Few studies have focused on oncological factors impacting cortical stimulation thresholds. OBJECTIVE: To examine oncological factors thought to impact stimulation threshold in order to understand whether a linear relationship exists between stimulation current and number of functional cortical sites identified. METHODS: We retrospectively reviewed single-institution prospectively collected brain mapping data of patients with dominant hemisphere gliomas. Comparisons of stimulation threshold were made using t-tests and ANOVAs. Associations between oncologic factors and stimulation threshold were made using multivariate regressions. The association between stimulation current and number of positive sites was made using a Poisson model. RESULTS: Of the 586 patients included in the study, SIS occurred in 3.92% and the rate of SIS events differed by cortical location (frontal 8.5%, insular 1.6%, parietal 1.3%, and temporal 2.8%; P = .009). Stimulation current was lower when mapping frontal cortex (P = .002). Stimulation current was not associated with tumor plus peritumor edema volume, world health organization) (WHO grade, histology, or isocitrate dehydrogenase (IDH) mutation status but was associated with tumor volume within the frontal lobe (P = .018). Stimulation current was not associated with number of positive sites identified during ECS mapping (P = .118). CONCLUSION: SISs are rare but serious events during ECS mapping. SISs are most common when mapping the frontal lobe. Greater stimulation current is not associated with the identification of more cortical functional sites during glioma surgery.
BACKGROUND:Gliomas are often in close proximity to functional regions of the brain; therefore, electrocortical stimulation (ECS) mapping is a common technique utilized during glioma resection to identify functional areas. Stimulation-induced seizure (SIS) remains the most common reason for aborted procedures. Few studies have focused on oncological factors impacting cortical stimulation thresholds. OBJECTIVE: To examine oncological factors thought to impact stimulation threshold in order to understand whether a linear relationship exists between stimulation current and number of functional cortical sites identified. METHODS: We retrospectively reviewed single-institution prospectively collected brain mapping data of patients with dominant hemisphere gliomas. Comparisons of stimulation threshold were made using t-tests and ANOVAs. Associations between oncologic factors and stimulation threshold were made using multivariate regressions. The association between stimulation current and number of positive sites was made using a Poisson model. RESULTS: Of the 586 patients included in the study, SIS occurred in 3.92% and the rate of SIS events differed by cortical location (frontal 8.5%, insular 1.6%, parietal 1.3%, and temporal 2.8%; P = .009). Stimulation current was lower when mapping frontal cortex (P = .002). Stimulation current was not associated with tumor plus peritumor edema volume, world health organization) (WHO grade, histology, or isocitrate dehydrogenase (IDH) mutation status but was associated with tumor volume within the frontal lobe (P = .018). Stimulation current was not associated with number of positive sites identified during ECS mapping (P = .118). CONCLUSION: SISs are rare but serious events during ECS mapping. SISs are most common when mapping the frontal lobe. Greater stimulation current is not associated with the identification of more cortical functional sites during glioma surgery.
Authors: Gewalin Aungaroon; Alonso Zea Vera; Paul S Horn; Anna W Byars; Hansel M Greiner; Jeffrey R Tenney; Todd M Arthur; Nathan E Crone; Katherine D Holland; Francesco T Mangano; Ravindra Arya Journal: Clin Neurophysiol Date: 2017-07-18 Impact factor: 3.708
Authors: Alonso Zea Vera; Gewalin Aungaroon; Paul S Horn; Anna W Byars; Hansel M Greiner; Jeffrey R Tenney; Todd M Arthur; Nathan E Crone; Katherine D Holland; Francesco T Mangano; Ravindra Arya Journal: Clin Neurophysiol Date: 2017-07-18 Impact factor: 3.708
Authors: S Uematsu; R Lesser; R S Fisher; B Gordon; K Hara; G L Krauss; E P Vining; R W Webber Journal: Neurosurgery Date: 1992-07 Impact factor: 4.654
Authors: Giannantonio Spena; Philippe Schucht; Kathleen Seidel; Geert-Jan Rutten; Christian Franz Freyschlag; Federico D'Agata; Emanule Costi; Francesca Zappa; Marco Fontanella; Denys Fontaine; Fabien Almairac; Michele Cavallo; Pasquale De Bonis; Gerardo Conesa; Nicholas Foroglou; Santiago Gil-Robles; Emanuel Mandonnet; Juan Martino; Thomas Picht; Catarina Viegas; Michel Wager; Johan Pallud Journal: Neurosurg Rev Date: 2016-08-01 Impact factor: 3.042