Abstract
The early steps in determining cortical functional organization during neurosurgical procedures were performed in awake patients and date back into the early 1930s [12, 30]. At that time, the identification and assessment of cortical functional organization within the vicinity of a brain pathology (e.g., tumor, epileptic foci) was possible only by direct electrical stimulation of the cerebral cortex. The observation of the elicited interference with the awake patient’s behavior, movement, and language performance served as guidance for the surgical tumor resection. Only in the late 1970s monitoring of somatosensory evoked potentials (SEP) and in the early 1990s monitoring of motor evoked potentials (MEPs) were introduced into the operating room. It was utilized in spine and spinal cord surgery and then for neurovascular procedures, before it was finally implemented into brain tumor surgery.
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Keywords
- Motor Cortex
- Somatosensory Evoke Poten
- Direct Cortical Stimulation
- Brain Tumor Surgery
- Postoperative Motor
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References
Agnew WF, McCreery DB (1987) Considerations for safety in the use of extracranial stimulation for motor evoked potentials. Neurosurgery 20: 143–147
Axelson HW, Hesselager G, Flink R (2009) Successful localization of the Broca area with short-train pulses instead of “Penfield” stimulation. Seizure 18: 374–375
Berger MS, Deliganis AV, Dobbins J, Keles GE. The effect of extent of resection on recurrence in patients with low grade cerebral hemisphere gliomas. Cancer 74: 1784–1791
Burke D, Hicks RG, Stephen JPH (1990) Corticospinal volleys evoked by anodal and cathodal stimulation of the human motor cortex. J Physiol 425: 283–299
Cedzich C, Taniguchi M, Schafer S, Schramm J (1996) Somatosensory evoked potential phase reversal and direct motor cortex stimulation during surgery in and around the central region. Neurosurgery 38: 962–970
Dawson GD (1947) Investigations on a patient subject to myoclonic seizures after sensory stimulation. J Neurol Neurosurg Psychiatry 10: 141–162
Deletis V, Sala F (2008) Corticospinal tract monitoring with D-and I-waves from the spinal cord and muscle MEPs from the limb muscles. In: Nuwer MR (ed) Intraoperative monitoring of neural function. Handbook of clinical neurophysiology, vol 8. Elsevier, Amsterdam, pp 235–251
Deletis V, Isgum V, Amassian VE (2001) Neurophysiological mechanisms underlying motor evoked potentials in anesthetized humans. Part 1. Recovery time of corticospinal tract waves elicited by pairs of transcranial electrical stimulation. Clin Neurophysiol 112: 438–444
Deletis V, Rodi Z, Amassian VE (2001) Neurophysiological mechanisms underlying motor evoked potentials in anesthetized humans. Part 2. Relationship between epidurally and muscle recorded MEPs in man. Clin Neurophysiol 112: 445–452
Di Lazzaro V, Oliviero A, Profice P, Saturno E, Pilato F, Insola A, Mazzone P, Tonali P, Rothwell JC (1998) Comparison of descending volleys evoked by transcranial magnetic and electric stimulation in conscious humans. Electroencephalogr Clin Neurophysiol 109: 397–401
Duffau H (2009) A personal consecutive series of surgically treated 51 cases of insular WHO grade II glioma: advances and limitations. J Neurosurg 110: 696–708
Foerster O, Penfield W (1930) The structural basis of traumatic epilepsy and results of radical operations. Brain 53: 99–119
Goldring S (1978) A method for surgical management of focal epilepsy, especially as it relates to children. J Neurosurg 49: 344–356
Gordon B, Lesser RP, Rance NE, Hart J,Jr., Webber R, Uematsu S, Fisher RS (1990) Parameters for direct cortical electrical stimulation in the human: histopathologic confirmation. Electroencephalogr Clin Neurophysiol 75: 371–377
Harding GF, Bland JD, Smith VH (1990) Visual evoked potential monitoring of optic nerve function during surgery. J Neurol Neurosurg Psychiatry 53: 890–895
Hattingen E, Hattingen J, Clusmann H, Meyer B, Koenig R, Urbach H (2004) Planar brain surface reformations for localization of cortical brain lesions. Zentralbl Neurochir 65: 75–80
Holland NR (1998) Subcortical strokes from intracranial aneurysm surgery: implications for intraoperative neuromonitoring. J Clin Neurophysiol 15: 439–446
Katayama Y, Tsubokawa T, Maejima S, Hirayama T, Yamamoto T (1988) Corticospinal direct response in humans: identification of the motor cortex during intracranial surgery under general anesthesia. J Neurol Neurosurg Psychiatry 51: 50–59
Keles GE, Lundin DA, Lamborn KR, Chang EF, Ojemann G, Berger MS (2004) Intraoperative subcortical stimulation mapping for hemispherical perirolandic gliomas located within or adjacent to the descending motor pathways: evaluation of morbidity and assessment of functional outcome in 294 patients. J Neurosurg 100: 369–375
King RB, Schell GR (1987) Cortical localization and monitoring during cerebral operations. J Neurosurg 67: 210–219
Kombos T, Suess O, Kern BC, Funk T, Hoell T, Kopetsch O, Brock M (1999) Comparison between monopolar and bipolar electrical stimulation of the motor cortex. Acta Neurochir (Wien) 41: 1295–1301
Krishnan R, Raabe A, Hattingen E, Szelenyi A, Yahya H, Hermann E, Zimmermann M, Seifert V (2004) Functional magnetic resonance imaging-integrated neuronavigation: correlation between lesion-to-motor cortex distance and outcome. Neurosurgery 55: 904–914
LeRoux PD, Berger MS, Haglund MM, Pilcher WH, Ojemann GA (1991) Resection of intrinsic tumors from nondominant face motor cortex using stimulation mapping: report of two cases. Surg Neurol 36: 44–48
MacDonald DB (2002) Safety of intraoperative transcranial electrical stimulation motor evoked potential monitoring. J Clin Neurophysiol 19: 416–429
MacDonald DB (2006) Intraoperative motor evoked potential monitoring: overview and update. J Clin Monit Comput 20: 347–377
Nash CL Jr, Lorig RA, Schatzinger LA, Brown RH (1977) Spinal cord monitoring during operative treatment of the spine. Clin Orthop Relat Res 126: 100–105
Neuloh G, Pechstein U, Cedzich C, Schramm J (2004) Motor evoked potential monitoring in supratentorial surgery. Neurosurgery 54: 1061–1072
Neuloh G, Pechstein U, Schramm J (2007) Motor tract monitoring during insular glioma surgery. J Neurosurg 106: 582–592
Patton HD, Amassian VE (1954) Single and multiple-unit analysis of cortical state of pyramidal tract activation. J Neurophysiol 17: 345–363
Penfield W, Boldrey E (1937) Somatic motor and sensory representation in the cerebral cortex of man as studied by electric stimulation. Brain 60: 389–443
Rothwell J, Burke D, Hicks R, Stephen J, Woodforth I, Crawford M (1994) Transcranial electrical stimulation of the motor cortex in man: further evidence for the site of activation. J Physiol 481: 243–250
Sala F, Lanteri P (2003) Brain surgery in motor areas: the invaluable assistance of intraoperative neurophysiological monitoring. J Neurosurg Sci 47: 79–88
Sartorius CJ, Berger MS (1998) Rapid termination of intraoperative stimulation-evoked seizures with application of cold Ringer’s lactate to the cortex. Technical note. J Neurosurg 88: 349–351
Sasaki T, Itakura T, Suzuki K, Kasuya H, Munakata R, Muramatsu H, Ichikawa T, Sato T, Endo Y, Sakuma J, Matsumoto M (2010) Intraoperative monitoring of visual evoked potential: introduction of a clinically useful method. J Neurosurg 112: 273–284
Szelenyi A, Hattingen E, Weidauer S, Seifert V, Ziemann U (2010) Intraoperative motor evoked potential alteration in intracranial tumor surgery and its relation to signal alteration in postoperative magnetic resonance imaging. Neurosurgery 67: 302–313
Szelenyi A, Joksimovic B, Seifert V (2007) Intraoperative risk of seizures associated with transient direct cortical stimulation in patients with symptomatic epilepsy. J Clin Neurophysiol 24: 39–43
Szelenyi A, Kothbauer K, de Camargo AB, Langer D, Flamm ES, Deletis V (2005) Motor evoked potential monitoring during cerebral aneurysm surgery: technical aspects and comparison of transcranial and direct cortical stimulation. Neurosurgery 57(Suppl 4): 331–338
Taniguchi M, Cedzich C, Schramm J (1993) Modification of cortical stimulation for motor evoked potentials under general anesthesia: technical description. Neurosurgery 32: 219–226
Wiedemayer H, Sandalcioglu IE, Armbruster W, Regel J, Schaefer H, Stolke D (2004) False negative findings in intraoperative SEP monitoring: analysis of 658 consecutive neurosurgical cases and review of published reports. J Neurol Neurosurg Psychiatry 75: 280–286
Wood CC, Spencer DD, Allison T, McCarthy G, Williamson PD, Goff WR (1988) Localization of human sensorimotor cortex during surgery by cortical surface recording of somatosensory evoked potentials. J Neurosurg 68: 99–111
Yingling CD, Ojemann S, Dodson B, Harrington MJ, Berger MS (1999) Identification of motor pathways during tumor surgery facilitated by multichannel electromyographic recording. J Neurosurg 91: 922–927
Zentner J, Hufnagel A, Pechstein U, Wolf HK, Schramm J (1996) Functional results after resective procedures involving the supplementary motor area. J Neurosurg 85: 542–549
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Szelényi, A. (2011). Intraoperative neurophysiological monitoring under general anesthesia. In: Duffau, H. (eds) Brain Mapping. Springer, Vienna. https://doi.org/10.1007/978-3-7091-0723-2_22
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DOI: https://doi.org/10.1007/978-3-7091-0723-2_22
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