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Motor Cortex/surgery

Daniel Schneider, Jan Hermann, Kate A Gerber, Juan Ansó, Marco D Caversaccio, Stefan Weber, Lukas Anschuetz
HYPOTHESIS: Combining novel registration strategies and advanced image guidance technology enable submillimeter accurate and noninvasive navigation for middle ear and lateral skull base surgery. BACKGROUND: Surgery in the internal auditory canal and the petrous apex present a cognitive and motoric challenge for the surgeon. To date, image guidance rarely assists these procedures, mainly due to the lack of navigation solutions providing submillimeter accuracy associated with low cost in terms of invasiveness, radiation, and time...
September 19, 2018: Otology & Neurotology
Tao Wen, Xiufeng Zhang, Shengxiang Liang, Zuanfang Li, Xuemei Xing, Weilin Liu, Jing Tao
BACKGROUND: To evaluate whether electroacupuncture (EA) at Baihui (DU20) and Shenting (DU24) acupoints could improve cognitive function and enhance spontaneous low-frequency brain activity in rats with ischemic stroke. METHODS: Total 36 rats were randomly divided into 3 groups-the sham surgery (Sham) group, the middle cerebral artery occlusion induced cognitive deficit (MICD) group, and the MICD with EA (MICD + EA) treatment group. The rats in MICD + EA group received EA treatment at DU20 and DU24 acupoints for 14 consecutive days after the surgery...
October 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Tammam Abboud, Cindy Schwarz, Manfred Westphal, Tobias Martens
OBJECTIVE The aim of this study was to compare sensitivity and specificity between the novel threshold and amplitude criteria for motor evoked potentials (MEPs) monitoring after transcranial electrical stimulation (TES) during surgery for supratentorial lesions in the same patient cohort. METHODS One hundred twenty-six patients were included. All procedures were performed under general anesthesia. Craniotomies did not expose motor cortex, so that direct mapping was less suitable. After TES, MEPs were recorded bilaterally from abductor pollicis brevis (APB), from orbicularis oris (OO), and/or from tibialis anterior (TA)...
September 7, 2018: Journal of Neurosurgery
Takafumi Tanei, Yasukazu Kajita, Satoshi Maesawa, Daisuke Nakatsubo, Kosuke Aoki, Hiroshi Noda, Shigenori Takebayashi, Norimoto Nakahara, Toshihiko Wakabayashi
The long-term effects of motor cortex stimulation (MCS) and spinal cord stimulation (SCS) remain unknown. To identify the long-term effects after MCS or SCS and determine any associated predictive factors for the outcomes. Fifty patients underwent MCS (n = 15) or SCS (n = 35) for chronic neuropathic pain. The degree of pain was assessed preoperatively, at 1, 6, and 12 months after surgery, and during the time of the last follow-up using Visual Analog Scale (VAS). Percentage of pain relief (PPR) was calculated, with "long-term effect" defined as PPR ≥ 30% and the presence of continued pain relief over 12 months...
August 30, 2018: Neurologia Medico-chirurgica
Didier Scavarda, Tiago Cavalcante, Agnès Trébuchon, Anne Lépine, Nathalie Villeneuve, Nadine Girard, Aileen McGonigal, Mathieu Milh, Fabrice Bartolomei
OBJECTIVE Hemispherotomy is currently the most frequently performed surgical option for refractory epilepsy associated with large perinatal or childhood ischemic events. Such an approach may lead to good seizure control, but it has inherent functional consequences linked to the disconnection of functional cortices. The authors report on 6 consecutive patients who presented with severe epilepsy associated with hemiplegia due to stroke and who benefitted from a new, stereoelectroencephalography-guided partial disconnection technique...
August 24, 2018: Journal of Neurosurgery. Pediatrics
G I Moysak, D A Rzaev, V M Dzhafarov, K V Slavin
OBJECTIVE: To demonstrate the results of treatment of poorly controlled deafferentation facial pain using motor cortex stimulation and to review the relevant literature. MATERIAL AND METHODS: The study included 8 patients (3 males and 5 females) with deafferentation facial pain who were implanted with a system of constant motor cortex stimulation at the Illinois University in Chicago in 2004-2016 and Novosibirsk Federal Center of Neurosurgery in 2017. The patients' age ranged from 37 to 81 years (mean age, 57...
2018: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
Xiaolei Zhang, Hongwei Zhu, Wei Tao, Yongjie Li, Yongsheng Hu
BACKGROUND: Motor cortex stimulation (MCS) has been used in the treatment of chronic neuropathic pain for more than 25 years. However, the mechanisms and outcome predictors still represent major challenges. OBJECTIVES: To investigate outcome predictors and potential mechanisms of MCS on central post-stroke pain (CPSP). MATERIAL AND METHODS: 16 CPSP patients were analyzed at our center. The pain intensity was assessed using a visual analog scale (VAS) before surgery and at the last follow-up...
August 20, 2018: Stereotactic and Functional Neurosurgery
Seunggu J Han, Ramin A Morshed, Irene Troncon, Kesshi M Jordan, Roland G Henry, Shawn L Hervey-Jumper, Mitchel S Berger
OBJECTIVE Herein, the authors report their experience with intraoperative stimulation mapping to locate the descending subcortical motor pathways in patients undergoing surgery for hemispheric gliomas within or adjacent to the rolandic cortex, with particular description of the morbidity and functional outcomes associated with this technique. METHODS This is a retrospective analysis of patients who, in the period between 1997 and 2016, had undergone resection of hemispheric perirolandic gliomas within or adjacent to descending motor pathways...
August 17, 2018: Journal of Neurosurgery
Zhenhong Wang, Wei Zhou, Haiping Dong, Xiaoxiao Ma, Zhenzhou He
Focal ischemia/reperfusion (I/R) injury induced cerebral inflammation, aggravates brain damage. The aim of the present study was to investigate the protective mechanisms of dexmedetomidine (DEX) on I/R brain injury in rats. Sprague‑Dawley rats were divided to seven experimental groups (18 rats/group): Sham surgery; middle cerebral artery occlusion (MCAO) surgery (90 min); DEX10 [10 µg/kg intraperitoneal (i.p.) injection 30 min prior to MCAO]; DEX50 (50 µg/kg i.p. 30 min prior to MCAO); DEX100 (100 µg/kg i...
August 3, 2018: Molecular Medicine Reports
Nobuo Yanagisawa
Involuntary movements and parkinsonism have been interesting and important topics in neurology since the last century. The development of anatomical and physiological studies of the neural circuitry of motor systems has encouraged the study of movement disorders by means of pathophysiology and brain imaging.Multichannel electromyography from affected muscles has generated objective and analytical data on chorea, ballism, athetosis, and dystonia. Studies using floor reaction forces revealed the pathophysiology of freezing of gait in parkinsonism...
2018: Proceedings of the Japan Academy. Series B, Physical and Biological Sciences
Efi Kazum, Oleg Dolkart, Yoav Rosenthal, Haggai Sherman, Eyal Amar, Moshe Salai, Eran Maman, Ofir Chechik
OBJECTIVE: Drilling through bone is a complex action that requires precise motor skills of an orthopedic surgeon. In order to minimize plunging and soft tissue damage, the surgeon must halt drill progression precisely following penetration of the far cortex. The purpose of this study was to create a low-cost and easy-to-use drilling simulator to train orthopedic residents in reducing the drill plunging depth. DESIGN, SETTING, PARTICIPANTS: This prospective observational study was performed in the division of orthopedic surgery of a single tertiary medical center...
August 2, 2018: Journal of Surgical Education
Kazuya Motomura, Lushun Chalise, Fumiharu Ohka, Kosuke Aoki, Kuniaki Tanahashi, Masaki Hirano, Tomohide Nishikawa, Toshihiko Wakabayashi, Atsushi Natsume
OBJECTIVE: An extended margin tumor resection beyond the abnormal area detected by magnetic resonance imaging, defined as supratotal resection, could improve the outcome of patients with lower-grade gliomas (LGGs). The aim of this study was to assess the surgical outcomes of awake brain mapping in order to achieve a supratotal resection while determining the normal brain tissue boundaries beyond the tumor of frontal LGGs, in both dominant and non-dominant hemispheres. METHODS: We analyzed nine patients with diffuse frontal LGGs who achieved supratotal resection with awake surgery between January 2016 and November 2017...
July 31, 2018: World Neurosurgery
Yusuke Tomita, Shoko Merrit Yamada, Shokei Yamada, Akira Matsuno
BACKGROUND: Hemiparesis is a major symptom of chronic subdural hematoma (CSDH). Its severity does not always correlate with hematoma size. The authors analyzed hematoma thickness, pressure, and tension to clarify the mechanism of hemiparesis in CSDH patients. METHODS: A burr-hole surgery was performed on 124 CSDHs in 102 patients. Hematoma thickness and midline shift were measured by computed tomography, and hematoma pressure was measured in surgery. According to Laplace law, tension was calculated as follows: (half the hematoma thickness × hematoma pressure)/2...
August 1, 2018: World Neurosurgery
Thomas A Ostergard, Jonathan P Miller
Surgical resection of the epileptogenic zone within the frontal lobe can be a very effective treatment for medically refractory epilepsy originating from this area. While much of the frontal lobe consists of highly eloquent tissue, surgery is not necessarily contraindicated as long as the epileptogenic zone is well-localized and the tissue resected is limited. Resection of the primary motor cortex was described by Victor Horsley in the 19th century and was used frequently in the early 20th century for a variety of neurological disorders including epilepsy; improvements in surgical techniques and mapping has led to a resurgence of its use in the past few decades...
July 23, 2018: Epilepsy & Behavior: E&B
Naifu Jiang, Guangsheng Li, Jinsong Wei, Bo Wei, Frank F Zhu, Yong Hu
BACKGROUND: Transcranial direct current stimulation (tDCS) on primary motor cortex (M1) provides a new way to relieve postoperative pain. Previous studies only found postoperative analgesia dosage significantly reduced in tDCS group while the patient-controlled analgesia (PCA) was applied. However, there lacks the study about the effect of M1-tDCS on pain intensity and brain activity while the analgesia dosage is the same for both groups. OBJECTIVE: To investigate whether M1-tDCS can (1) reduce pain intensity and (2) change spontaneous electroencephalography (EEG) oscillations in prefrontal cortex, in patients with postoperative pain, after taking the constant dosage of analgesics...
July 18, 2018: Restorative Neurology and Neuroscience
Jose Gomez-Tames, Akimasa Hirata, Manabu Tamura, Yoshihiro Muragaki
Intraoperative neurophysiological monitoring during brain surgery uses direct cortical stimulation to map the motor cortex by recording muscle activity induced by the excitation of alpha motor neurons (MNs). Computational models have been used to understand local brain stimulation. However, a computational model revealing the stimulation process from the cortex to MNs has not yet been proposed. Thus, the aim of the current study was to develop a corticomotoneuronal (CMN) model to investigate intraoperative stimulation during surgery...
June 18, 2018: International Journal of Neural Systems
P Ciechanski, A Cheng, O Damji, S Lopushinsky, K Hecker, Z Jadavji, A Kirton
Background: Changes in medical education may limit opportunities for trainees to gain proficiency in surgical skills. Transcranial direct-current stimulation (tDCS) can augment motor skill learning and may enhance surgical procedural skill acquisition. The aim of this study was to determine the effects of tDCS on simulation-based laparoscopic surgical skill acquisition. Methods: In this double-blind, sham-controlled randomized trial, participants were randomized to receive 20 min of anodal tDCS or sham stimulation over the dominant primary motor cortex, concurrent with Fundamentals of Laparoscopic Surgery simulation-based training...
April 2018: BJS open
Torsten Gordh, Bertil Vinnars, Håkan Fischer, Hans Blomberg, Jan Modig, Mats Fredrikson, Per Hartvig
Background Brain activation resulting from acute postoperative pain has to our knowledge not previously been studied using positron emission tomography, except from one case study. The aim of this study was to monitor activation in brain sensory pathways during acute pain after surgery of the hand. A secondary aim was to compare brain activation in clinical postoperative pain to that previously reported, by the same research group, for a model of experimental pain from the same body area. Increase in regional cerebral blood flow (rCBF) is presumed to indicate neuronal activation and decrease in blood flow decreased neuronal firing...
July 1, 2010: Scandinavian Journal of Pain
Gerd Tinkhauser, Flavie Torrecillos, Yann Duclos, Huiling Tan, Alek Pogosyan, Petra Fischer, Romain Carron, Marie-Laure Welter, Carine Karachi, Wim Vandenberghe, Bart Nuttin, Tatiana Witjas, Jean Régis, Jean-Philippe Azulay, Alexandre Eusebio, Peter Brown
Exaggerated activity in the beta band (13-35 Hz) is a hallmark of basal ganglia signals in patients with Parkinson's disease (PD). Beta activity however is not constantly elevated, but comes in bursts. In previous work we showed that the longer beta bursts are maintained, the more the oscillatory synchronisation within the subthalamic nucleus (STN) increases, which is posited to limit the information coding capacity of local circuits. Accordingly, a higher incidence of longer bursts correlates positively with clinical impairment, while the opposite is true for short, more physiological bursts...
September 2018: Neurobiology of Disease
Ivair Matias, Daoud Hibrahim Elias-Filho, Camila Araújo Bernardino Garcia, Guilherme Henrique Silva, Jorge Mejia, Francisco Romero Cabral, Ana Cláudia Camargo Miranda, Sérgio Gomes da Silva, Luíza da Silva Lopes, Norberto Cysne Coimbra, Hélio Rubens Machado
OBJECTIVE The objective of this study was to describe a new experimental model of hemispherotomy performed on laboratory animals. METHODS Twenty-six male young adult Wistar rats were distributed into two groups (surgery and control). The nonfluorescent anterograde neurotracer biotinylated dextran amine (BDA; 10,000 MW) was microinjected into the motor cortex area (M1) according to The Rat Brain in Stereotaxic Coordinates atlas to identify pathways and fibers disconnected after the experimental hemispherectomy...
June 8, 2018: Journal of Neurosurgery
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