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Motor Cortex/surgery

Roni Zelitzki, Akiva Korn, Eti Arial, Carmit Ben-Harosh, Zvi Ram, Rachel Grossman
BACKGROUND: Surgical removal of intra-axial brain tumors aims at maximal tumor resection while preserving function. The potential benefit of awake craniotomy over craniotomy under general anesthesia (GA) for motor preservation is yet unknown. OBJECTIVE: To compare the clinical outcomes of patients who underwent surgery for perirolandic tumors while either awake or under GA. METHODS: Between 2004 and 2015, 1126 patients underwent surgical resection of newly diagnosed intra-axial tumors in a single institution...
February 20, 2019: Neurosurgery
Luiz Alexandre Viana Magno, Helia Tenza-Ferrer, Mélcar Collodetti, Matheus Felipe Guimarães Aguiar, Ana Paula Carneiro Rodrigues, Rodrigo Souza da Silva, Joice do Prado Silva, Nycolle Ferreira Nicolau, Daniela Valadão Freitas Rosa, Alexander Birbrair, Débora Marques Miranda, Marco Aurélio Romano-Silva
Neuromodulation of deep brain structures (deep brain stimulation - DBS) is the current surgical procedure for treatment of Parkinson's disease. Less studied is the stimulation of cortical motor areas to treat PD symptoms, although also known to alleviate motor disturbances in PD. We were able to show that optogenetic activation of secondary (M2) motor cortex improves motor functions in dopamine-depleted male mice. The stimulated M2 cortex harbors glutamatergic pyramidal neurons that project to subcortical structures, critically involved in motor control, and makes synaptic contacts with dopaminergic neurons...
February 19, 2019: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
D J H A Henssen, R L Witkam, J C M L Dao, D J Comes, A M Van Cappellen van Walsum, T Kozicz, Robert van Dongen, K Vissers, R H M A Bartels, G de Jong, E Kurt
Implantable Motor Cortex Stimulation (iMCS) has been performed for over 25 years to treat various intractable pain syndromes. Its effectiveness shows to be highly variable and although various studies revealed predictive variables, none of these were found repeatedly. This study uses neural network analysis (NNA) to identify predictive factors of iMCS treatment of intractable pain. A systematic review provided a database of patient data on an individual level of patients who underwent iMCS to treat refractory pain between 1991 and 2017...
February 13, 2019: Journal of Pain: Official Journal of the American Pain Society
Xiangrong Li, Chengjun Wang, Zhiqin Lin, Meng Zhao, Xiaohui Ren, Xiaohui Zhang, Zhongli Jiang
This retrospective study explored the risk factors for the occurrence of seizures in the pre- and postoperative period in patients undergoing supratentorial meningiomas surgery to investigate those who are likely to benefit from prophylactic antiepileptic drugs (AEDs). We reviewed the medical records of 778 supratentorial meningiomas patients who were operated at our institution between 2011 and 2012. A total of 100 (12.9%) patients experienced preoperative seizures; 41 patients (5.3%) experienced postoperative in-hospital seizures, and 91 (13...
February 15, 2019: Neurosurgical Review
Fabien Rech, Guillaume Herbet, Yann Gaudeau, Sophie Mézières, Jean-Marie Moureau, Sylvie Moritz-Gasser, Hugues Duffau
Negative motor responses (NMRs) are defined as movement arrests induced by direct electrical stimulation of the brain. The NMRs manifest themselves after the disruption of a corticosubcortical network involved in motor control, referred to as the 'negative motor network'. At present, the spatial topography of the negative motor areas (NMAs) is poorly known. Hence, the objectives of the present study were to establish the first probabilistic map of the NMAs of the upper limbs and face, identify potential subareas, and investigate the NMAs' relationships with the primary motor cortex...
February 7, 2019: Brain: a Journal of Neurology
Riho Nakajima, Masashi Kinoshita, Tetsutaro Yahata, Mitsutoshi Nakada
OBJECTIVESupplementary motor area (SMA) syndrome is defined as temporary paralysis after the resection of brain tumor localized in the SMA. Although in most cases paralysis induced by SMA resection resolves within a short period, the time until complete recovery varies and has not been precisely analyzed to date. In this study, the authors investigated factors for predicting the time required for recovery from paralysis after SMA resection.METHODSData from 20 cases were analyzed. All 20 patients (mean age 54...
February 8, 2019: Journal of Neurosurgery
Laura Seynaeve, Tom Haeck, Markus Gramer, Frederik Maes, Steven De Vleeschouwer, Wim Van Paesschen
BACKGROUND AND OBJECTIVE: Transcranial magnetic stimulation (TMS) is a useful technique to help localize motor function prior to neurosurgical procedures. Adequate modelling of the effect of TMS on the brain is a prerequisite to obtain reliable data. METHODS: Twelve patients were included with perirolandic tumors to undergo TMS-based motor mapping. Several models were developed to analyze the mapping data, from a projection to the nearest brain surface to motor evoked potential (MEP) amplitude informed weighted average of the induced electric fields over a multilayer detailed individual head model...
January 9, 2019: NeuroImage: Clinical
Jon T Willie, James G Malcolm, Matthew A Stern, Lindsay O Lowder, Stewart G Neill, Brian T Cabaniss, Daniel L Drane, Robert E Gross
OBJECTIVE: Magnetic resonance (MR) thermography-guided laser interstitial thermal therapy, or stereotactic laser ablation (SLA), is a minimally invasive alternative to open surgery for focal epilepsy caused by cerebral cavernous malformations (CCMs). We examined the safety and effectiveness of SLA of epileptogenic CCMs. METHODS: We retrospectively analyzed 19 consecutive patients who presented with focal seizures associated with a CCM. Each patient underwent SLA of the CCM and adjacent cortex followed by standard clinical and imaging follow-up...
January 17, 2019: Epilepsia
Anke Ninija Karabanov, Friederike Irmen, Kristoffer Hougaard Madsen, Brian Numelin Haagensen, Svend Schulze, Thue Bisgaard, Hartwig Roman Siebner
Endoscopic surgery requires skilled bimanual use of complex instruments that extend the peri-personal workspace. To delineate brain structures involved in learning such surgical skills, 48 medical students without surgical experience were randomly assigned to five training sessions on a virtual-reality endoscopy simulator or to a non-training group. Brain activity was probed with functional MRI while participants performed endoscopic tasks. Repeated task performance in the scanner was sufficient to enhance task-related activity in left ventral premotor cortex (PMv) and the anterior Intraparietal Sulcus (aIPS)...
December 21, 2018: NeuroImage
Mu Zhang, Zhen-Li Tang, Li-Wen Wu, Li Yang, Xiao-Le Wang, Fei Yin, Jing Peng, Chen Chen
OBJECTIVE: To investigate the etiology and clinical features of epilepsia partialis continua (EPC) in children. METHODS: A retrospective analysis was performed for the clinical features, diagnosis and treatment of six children with EPC, and the clinical and laboratory features and prognosis were compared between the children with different etiologies. RESULTS: There were five girls and one boy, with an onset age ranging from one year and seven months to nine years...
December 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
Kang-Un Kim, Joon Hyuk Choi, Gun Woo Lee
RATIONALE: We report on a patient with a positron emission tomography/computed tomography scans (PET/CT)-negative malignant spine tumor, which had even caused a pathologic fracture, and was eventually confirmed on surgical biopsy. PATIENT CONCERNS: A 67-year-old man visited our emergency department with sudden onset of lower extremities paraplegia after slip down. On examination, gradually increasing paralysis was observed in both lower limbs. DIAGNOSES: Plain radiograph and CT showed an acute burst fracture at T12 with an osteolytic mass lesion within the vertebral body and pedicle, causing severe encroachment of the spinal canal...
December 2018: Medicine (Baltimore)
Darrin J Lee, Robert F Dallapiazza, Philippe De Vloo, Gavin J B Elias, Anton Fomenko, Alexandre Boutet, Peter Giacobbe, Andres M Lozano
BACKGROUND: Several different surgical procedures targeting the limbic circuit have been utilized for severe, treatment resistant obsessive-compulsive disorder; however, there has only been limited exploration of the inferior thalamic peduncle (ITP). The aim of this study was to determine the safety and initial efficacy of ITP deep brain stimulation (DBS) in patients with severe obsessive-compulsive disorder. METHODS: Patients with severe, treatment-refractory obsessive-compulsive disorder were enrolled into this open-label phase 1 DBS pilot study...
November 27, 2018: Brain Stimulation
Jitender Chaturvedi, Malla Bhaskara Rao, A Arivazhagan, Sanjib Sinha, Anita Mahadevan, M Ravindranadh Chowdary, K Raghavendra, A S Shreedhara, Nupur Pruthi, Jitender Saini, Rose Dawn Bharath, Jamuna Rajeswaran, P Satishchandra
Aim: Surgery for drug resistant epilepsy (DRE) with focal cortical dysplasia (FCD) often requires multiple non-invasive as well as invasive pre-surgical evaluations and innovative surgical strategies. There is limited data regarding surgical management of people with FCD as the underlying substrate for DRE among the low and middle-income countries (LAMIC) including India. Methodology: The presurgical evaluation, surgical strategy and outcome of 52 people who underwent resective surgery for DRE with FCD between January 2008 and December 2016 were analyzed...
November 2018: Neurology India
(no author information available yet)
OBJECTIVENeurovascular coupling reflects the link between neural activity and changes in cerebral blood flow. Despite many technical advances in functional exploration of the brain, including functional MRI, there are only a few reports of direct evidence of neurovascular coupling in humans. The authors aimed to explore, for the first time in humans, the local cerebral blood flow of the primary motor cortex using ultra-high-frequency ultrasound (UHF-US) Doppler imaging to detect low blood flow velocity (1 mm/sec)...
November 1, 2018: Journal of Neurosurgery
(no author information available yet)
OBJECTIVEResting-state functional MRI (rs-fMRI) represents a promising and cost-effective alternative to task-based fMRI for presurgical mapping. However, the lack of clinically streamlined and reliable rs-fMRI analysis tools has prevented wide adoption of this technique. In this work, the authors introduce an rs-fMRI processing pipeline (ReStNeuMap) for automatic single-patient rs-fMRI network analysis.METHODSThe authors provide a description of the rs-fMRI network analysis steps implemented in ReStNeuMap and report their initial experience with this tool after performing presurgical mapping in 6 patients...
October 1, 2018: Journal of Neurosurgery
D B MacDonald, C Dong, R Quatrale, F Sala, S Skinner, F Soto, A Szelényi
Intraoperative somatosensory evoked potentials (SEPs) provide dorsal somatosensory system functional and localizing information, and complement motor evoked potentials. Correct application and interpretation require in-depth knowledge of relevant anatomy, electrophysiology, and techniques. It is advisable to facilitate cortical SEPs with total intravenous propofol-opioid or similarly favorable anesthesia. Moreover, SEP optimization is recommended to enhance surgical feedback speed and accuracy by maximizing signal-to-noise ratio (SNR); it consists of selecting highest-SNR peripheral and cortical derivations while omitting low-SNR channels...
November 14, 2018: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
Prajwal Ghimire, Nurit Bedussa, Anastasios Giamouriadis, Christian Brogna, Noemia Pereira, Henrietta Howells, Ranj Bhangoo, Keyoumars Ashkan, Francesco Vergani
This study aimed at describing the first case of subcortical stimulation of the corticospinal tract leading to selective contraction of the intercostal muscles during surgery for removal of a tumour centred in the right central lobule/supplementary motor area. A 53-year-old male presented with partial motor seizures. Imaging demonstrated a low-grade glioma affecting the posterior aspect of the superior and middle frontal gyri and invading the precentral gyrus. Preoperative motor Transcranial Magnetic Stimulation and advanced diffusion tractography were performed to establish the relationship of the tumour with the motor cortex and corticospinal tract...
November 20, 2018: Brain Structure & Function
Tianxiao Jiang, Tao Jiang, Taylor Wang, Shanshan Mei, Qingzhu Liu, Yunlin Li, Xiaofei Wang, Sujit Prabhu, Zhiyi Sha, Nuri F Ince
Electrocorticogram (ECoG) has been used as a reliable modality to control a brain machine interface (BMI). Recently, promising results of high-density ECoG have shown that non redundant information can be recorded with finer spatial resolution from the cortical surface. In this study, highdensity ECoG was recorded intraoperatively from two patients during awake brain surgery while performing instructed hand flexion and extension. Event related desynchronization (ERD) were found in the low frequency band (LFB: 8-32 Hz) band while event related synchronization (ERS) were found in the high frequency band (HFB: 60-200 Hz)...
July 2018: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Sander De Groote, Mats De Jaeger, Peter Van Schuerbeek, Stefan Sunaert, Ronald Peeters, Dirk Loeckx, Lisa Goudman, Patrice Forget, Ann De Smedt, Maarten Moens
Background and purpose: Failed back surgery syndrome (FBSS) is a common and devastating chronic neuropathic pain disorder. Conventional spinal cord stimulation (SCS) applies electrical suprathreshold pulses to the spinal cord at a frequency of 40-60 Hz and relieves pain in FBSS patients. During the last decade, two major changes have emerged in the techniques of stimulating the spinal cord: paresthesia-free or subthreshold stimulation and administration of higher frequency or higher amounts of energy to the spinal cord...
2018: Journal of Pain Research
Hui Jae Do, Han Gil Seo, Byung-Mo Oh, Chul-Kee Park, Jin Wook Kim, Young Doo Choi, Seung Hak Lee
Transcranial electrical stimulation-motor evoked potential (TES-MEP) is a valuable intraoperative monitoring technique during brain tumor surgery. However, TES can stimulate deep subcortical areas located far from the motor cortex. There is a concern about false-negative results from the use of TES-MEP during resection of those tumors adjacent to the primary motor cortex. Our study reports three cases of TES-MEP monitoring with false-negative results due to deep axonal stimulation during brain tumor resection...
October 2018: Annals of Rehabilitation Medicine
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