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Motor Cortex/surgery

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https://www.readbyqxmd.com/read/28643843/perisylvian-including-insular-childhood-epilepsy-presurgical-workup-and-surgical-outcome
#1
Elena Freri, Sara Matricardi, Francesca Gozzo, Massimo Cossu, Tiziana Granata, Laura Tassi
OBJECTIVE: To report the presurgical workup, surgical procedures, and outcomes in a series of pediatric patients with drug-resistant epilepsy involving the perisylvian/insular regions. METHODS: We retrospectively assessed 16 pediatric patients affected by drug-resistant focal epilepsy involving perisylvian/insular regions, who consecutively underwent tailored resective surgery. All patients underwent a detailed presurgical workup, which included the analysis of the anatomoelectroclinical correlations with scalp electroencephalography (EEG) and/or with stereo-electroencephalography (SEEG), brain magnetic resonance imaging (MRI), and comprehensive cognitive and neuropsychological evaluations...
June 23, 2017: Epilepsia
https://www.readbyqxmd.com/read/28616385/neurophysiological-evidence-of-preserved-connectivity-in-tuber-tissue
#2
H L Kaye, J M Peters, R Gersner, M Chamberland, A Sansevere, A Rotenberg
We present a case of preserved corticospinal connectivity in a cortical tuber, in a 10 year-old boy with intractable epilepsy and tuberous sclerosis complex (TSC). The patient had multiple subcortical tubers, one of which was located in the right central sulcus. In preparation for epilepsy surgery, motor mapping, by neuronavigated transcranial magnetic stimulation (nTMS) coupled with surface electromyography (EMG) was performed to locate the primary motor cortical areas. The resulting functional motor map revealed expected corticospinal connectivity in the left precentral gyrus...
2017: Epilepsy & Behavior Case Reports
https://www.readbyqxmd.com/read/28602887/cross-modal-recruitment-of-auditory-and-orofacial-areas-during-sign-language-in-a-deaf-subject
#3
Juan Martino, Carlos Velasquez, Javier Vázquez-Bourgon, Enrique Marco de Lucas, Elsa Gomez
BACKGROUND: Modern signed languages of the deaf are fully expressive, natural human languages that are perceived visually and produced manually.The literature contains little data concerning human brain organization in conditions of deficient sensory information such as deafness. CASE DESCRIPTION: Here, we describe an original case of a deaf-mute patient with a left temporo-insular low-grade glioma that was operated. The patient underwent awake surgery with intraoperative electrical stimulation mapping, allowing for the first time in the literature, to directly study the cortical and subcortical organization of signed language...
June 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28598277/surgical-strategy-to-avoid-ischemic-complications-of-the-pyramidal-tract-in-resective-epilepsy-surgery-of-the-insula-technical-case-report
#4
Naoki Ikegaya, Akio Takahashi, Takanobu Kaido, Yuu Kaneko, Masaki Iwasaki, Nobutaka Kawahara, Taisuke Otsuki
Surgical treatment of the insula is notorious for its high probability of motor complications, particularly when resecting the superoposterior part. Ischemic damage to the pyramidal tract in the corona radiata has been regarded as the cause of these complications, resulting from occlusion of the perforating arteries to the pyramidal tract through the insular cortex. The authors describe a strategy in which a small piece of gray matter is spared at the bottom of the periinsular sulcus, where the perforating arteries pass en route to the pyramidal tract, in order to avoid these complications...
June 9, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28583455/brain-arteriovenous-malformations-located-in-premotor-cortex-surgical-outcomes-and-risk-factors-for-postoperative-neurological-deficits
#5
Yuming Jiao, Fuxin Lin, Jun Wu, Hao Li, Xin Chen, Zhicen Li, Ji Ma, Yong Cao, Shuo Wang, Jizong Zhao
OBJECT: The premotor cortex (PMC) is known to have a dual role in both movement and language processing. Nevertheless, surgical outcomes of premotor cortex BAVMs (PMC-BAVMs) have not been well-defined. The aim of this study was to determine the surgical outcomes and risk factors for neurological deficits (ND) after surgery in patients with PMC-BAVMs. METHODS: We retrospectively reviewed patients with PMC-BAVMs who underwent surgical resection of the nidus. All patients had undergone preoperative functional MRI (fMRI), diffusion tensor imaging (DTI), MRI, 3D time-of-flight MRA (3D TOF-MRA) and digital subtraction angiography (DSA)...
June 2, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28533620/benefits-of-using-transcranial-magnetic-stimulation-as-a-tool-to-facilitate-the-chronic-knee-injury-rehabilitation
#6
Jae-Moo Lee, Ji-Hang Lee
[Purpose] While primary motor cortex activation has been implicated as a key factor in the arthrogenic muscle inhibition after knee joint injury, no viable rehabilitation protocol has been developed to accommodate this factor. In this study, transcranial magnetic stimulation was applied as a means of dissipating arthrogenic muscle inhibition by introducing temporary motor cortex excitation prior to the rehabilitation. [Subjects and Methods] Twenty-four subjects who have underwent the surgery due to knee injury were recruited, and randomly assigned to the control or the simulation groups...
April 2017: Journal of Physical Therapy Science
https://www.readbyqxmd.com/read/28523425/characterization-of-electrocorticogram-high-gamma-signal-in-response-to-varying-upper-extremity-movement-velocity
#7
Po T Wang, Colin M McCrimmon, Christine E King, Susan J Shaw, David E Millett, Hui Gong, Luis A Chui, Charles Y Liu, Zoran Nenadic, An H Do
The mechanism by which the human primary motor cortex (M1) encodes upper extremity movement kinematics is not fully understood. For example, human electrocorticogram (ECoG) signals have been shown to modulate with upper extremity movements; however, this relationship has not been explicitly characterized. To address this issue, we recorded high-density ECoG signals from patients undergoing epilepsy surgery evaluation as they performed elementary upper extremity movements while systematically varying movement speed and duration...
May 18, 2017: Brain Structure & Function
https://www.readbyqxmd.com/read/28506485/surgery-for-dysembryoplastic-neuroepithelial-tumors-and-gangliogliomas-in-eloquent-areas-functional-results-and-seizure-control
#8
B Devaux, F Chassoux, E Landré, B Turak, A Laurent, M Zanello, C Mellerio, P Varlet
INTRODUCTION: Dysembryoplastic neuroepithelial tumors and gangliogliomas are developmental glioneuronal tumors usually revealed by partial epilepsy. High epileptogenicity, childhood epilepsy onset, drug-resistance, temporal location, and seizure freedom after complete resection are common characteristics of both tumors. We report the specificity of surgical management, functional results and seizure outcome in cases of a tumor location in eloquent areas. METHODS: Among 150 patients (88 males, 3-55 years) operated on for refractory epilepsy due to a glioneuronal tumor (1990-2015), 30 (20%, dysembryoplastic neuroepithelial tumors=21; gangliogliomas=9) had a tumor located in an eloquent cortex (sensory-motor, insular or language areas)...
May 12, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28475998/refractory-focal-motor-seizures-controlled-with-intramuscular-botulinum-toxin
#9
Wei-I Lee, Patrick W Carney, Andrew J Hughes, John S Archer
Patients with recurrent focal motor seizures present a management dilemma, as anti-convulsants are often ineffective, and resective surgery poses a high risk of motor deficit. We describe three patients with recurrent focal motor seizures that remained refractory despite numerous anti-convulsant trials. All patients showed either hyperperfusion on Single-Photon Emission Computerised Tomography (SPECT) or hypermetabolism on Positron Emission Tomography (PET) in primary motor cortex during periods of sustained jerking, although EEG abnormalities were uncommon...
July 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28458383/efficacy-of-fiber-tractography-in-the-stereotactic-surgery-of-the-thalamus-for-patients-with-essential-tremor
#10
Susumu Sasada, Takashi Agari, Tatsuya Sasaki, Akihiko Kondo, Aiko Shinko, Takaaki Wakamori, Mihoko Okazaki, Ittetsu Kin, Ken Kuwahara, Masahiro Kameda, Takao Yasuhara, Isao Date
Several targets and targeting methods are utilized in stereotactic surgery to achieve tremor suppression for patients with intractable tremor. Recent developments in magnetic resonance imaging, including diffusion tensor imaging, have enabled the setting of appropriate targets in stereotactic surgery. In this retrospective study, the optimal target to suppress tremors in stereotactic surgery was explored using diffusion tensor image-based fiber tractography. Four tracts were focused on in this study, namely: the cerebello-thalamo-premotor cortical fiber tract, cerebello-thalamo-primary motor cortical fiber tract, spino-thalamo-somatosensory cortical fiber tract, and pyramidal tract...
May 1, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28452617/intradiploic-encephalocele-of-the-primary-motor-cortex-in-an-adult-patient-electrophysiological-implications-during-surgery
#11
Luca Valci, Martina Dalolio, Dominique Kuhlen, Emanuele Pravatà, Claudio Gobbi, Michael Reinert
Encephaloceles are herniations of brain parenchyma through congenital or acquired osseous-dural defects of the skull base or cranial vault. Different types of symptoms, due to CSF fistulas, meningitis, or seizures, are often associated with this condition. The authors present a rare case of spontaneous right frontal parasagittal encephalocele in a 70-year-old man who was experiencing a spastic progressive paresis of his left lower limb. Results of routine electrophysiological workup (motor evoked potentials, somatosensory evoked potentials, and electroneuromyography), as well as those of MRI of the spinal cord, were normal...
April 28, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28405611/long-term-follow-up-of-a-randomized-aav2-gad-gene-therapy-trial-for-parkinson-s-disease
#12
Martin Niethammer, Chris C Tang, Peter A LeWitt, Ali R Rezai, Maureen A Leehey, Steven G Ojemann, Alice W Flaherty, Emad N Eskandar, Sandra K Kostyk, Atom Sarkar, Mustafa S Siddiqui, Stephen B Tatter, Jason M Schwalb, Kathleen L Poston, Jaimie M Henderson, Roger M Kurlan, Irene H Richard, Christine V Sapan, David Eidelberg, Matthew J During, Michael G Kaplitt, Andrew Feigin
BACKGROUND. We report the 12-month clinical and imaging data on the effects of bilateral delivery of the glutamic acid decarboxylase gene into the subthalamic nuclei (STN) of advanced Parkinson's disease (PD) patients. METHODS. 45 PD patients were enrolled in a 6-month double-blind randomized trial of bilateral AAV2-GAD delivery into the STN compared with sham surgery and were followed for 12 months in open-label fashion. Subjects were assessed with clinical outcome measures and (18)F-fluorodeoxyglucose (FDG) PET imaging...
April 6, 2017: JCI Insight
https://www.readbyqxmd.com/read/28384595/clinical-outcomes-from-maximum-safe-resection-of-primary-and-metastatic-brain-tumors-using-awake-craniotomy
#13
Anastasia Groshev, Devang Padalia, Sephalie Patel, Rosemarie Garcia-Getting, Solmaz Sahebjam, Peter A Forsyth, Frank D Vrionis, Arnold B Etame
OBJECTIVE: To retrospectively analyze outcomes in patients undergoing awake craniotomies for tumor resection at our institution in terms of extent of resection, functional preservation and length of hospital stay. PATIENTS AND METHODS: All cases of adults undergoing awake-craniotomy from September 2012-February 2015 were retrospectively reviewed based on an IRB approved protocol. Information regarding patient age, sex, cancer type, procedure type, location, hospital stay, extent of resection, and postoperative complications was extracted...
June 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28356560/brain-activity-in-the-right-frontal-pole-and-lateral-occipital-cortex-predicts-successful-post-operatory-outcome-after-surgery-for-anterior-glenoumeral-instability
#14
Davide Zanchi, Gregory Cunningham, Alexandre Lädermann, Mehmet Ozturk, Pierre Hoffmeyer, Sven Haller
Shoulder apprehension is more complex than a pure mechanical problem of the shoulder, creating a scar at the brain level that prevents the performance of specific movements. Surgery corrects for shoulder instability at the physical level, but a re-dislocation within the first year is rather common. Predicting which patient will be likely to have re-dislocation is therefore crucial. We hypothesized that the assessment of neural activity at baseline and follow-up is the key factor to predict the post-operatory outcome...
March 29, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28338437/contralateral-peripheral-neurotization-for-a-hemiplegic-hindlimb-after-central-neurological-injury
#15
Mou-Xiong Zheng, Xu-Yun Hua, Su Jiang, Yan-Qun Qiu, Yun-Dong Shen, Wen-Dong Xu
OBJECTIVE Contralateral peripheral neurotization surgery has been successfully applied to rescue motor function of the hemiplegic upper extremity in patients with central neurological injury (CNI). It may contribute to strengthened neural pathways between the contralesional cortex and paretic limbs. However, the effect of this surgery in the lower extremities remains unknown. In the present study the authors explored the effectiveness and safety of contralateral peripheral neurotization in treating a hemiplegic lower extremity following CNI in adult rats...
March 24, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28291212/-surgical-treatment-of-eloquent-brain-area-tumors-using-neurophysiological-mapping-of-the-speech-and-motor-areas-and-conduction-tracts
#16
A A Zuev, E N Korotchenko, D S Ivanova, N V Pedyash, B A Teplykh
AIM: To evaluate the efficacy of intraoperative neurophysiological mapping in removing eloquent brain area tumors (EBATs). MATERIAL AND METHODS: Sixty five EBAT patients underwent surgical treatment using intraoperative neurophysiological mapping at the Pirogov National Medical and Surgical Center in the period from 2014 to 2015. On primary neurological examination, 46 (71%) patients were detected with motor deficits of varying severity. Speech disorders were diagnosed in 17 (26%) patients...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28259880/modified-fluorodeoxyglucose-metabolism-in-motor-circuitry-by-subthalamic-deep-brain-stimulation
#17
Chunyan Cao, Huiwei Zhang, Dianyou Li, Shikun Zhan, Jing Zhang, Xiaoxiao Zhang, Chuantao Zuo, Bomin Sun
BACKGROUND: Adjustment of the motor circuitry has been described in the treatment of Parkinson disease (PD). OBJECTIVES: To evaluate the modulation of the motor circuitry of PD patients by subthalamic deep brain stimulation (STN DBS) using 18F-fluorodeoxyglucose (FDG) and positron emission tomography (PET). METHODS: Resting-state brain 18F-FDG PET imaging was performed for 8 PD patients before surgery and also 1 year after STN DBS treatment; changes in regional glucose metabolism were identified...
2017: Stereotactic and Functional Neurosurgery
https://www.readbyqxmd.com/read/28249830/epileptic-zone-resection-for-magnetic-resonance-imaging-negative-refractory-epilepsy-originating-from-the-primary-motor-cortex
#18
Guangming Zhang, Dawei Meng, Yanwu Liu, Kai Yang, Jianwei Chen, Lanmei Su, Zhaozhao Zhang, Guoqiang Chen
OBJECTIVE: Because of the balance between achieving complete seizure freedom and minimizing the postoperative neurologic deficits, surgery for refractory epilepsy originating from the primary motor cortex is difficult. Here, we report the outcomes of surgery for magnetic resonance imaging-negative refractory epilepsy originating from the primary motor cortex in a case series. METHODS: Nine patients with refractory epilepsy originating from the primary motor cortex underwent intracranial electrodes implantation after preoperative evaluation...
June 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28245732/cortical-plasticity-after-brachial-plexus-injury-and-repair-a-resting-state-functional-mri-study
#19
Dhananjaya I Bhat, B Indira Devi, Komal Bharti, Rajanikant Panda
OBJECTIVE The authors aimed to understand the alterations of brain resting-state networks (RSNs) in patients with pan-brachial plexus injury (BPI) before and after surgery, which might provide insight into cortical plasticity after peripheral nerve injury and regeneration. METHODS Thirty-five patients with left pan-BPI before surgery, 30 patients after surgery, and 25 healthy controls underwent resting-state functional MRI (rs-fMRI). The 30 postoperative patients were subdivided into 2 groups: 14 patients with improvement in muscle power and 16 patients with no improvement in muscle power after surgery...
March 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28156205/metabolite-and-functional-profile-of-patients-with-cervical-spondylotic-myelopathy
#20
Izabela Aleksanderek, Todd K Stevens, Sandy Goncalves, Robert Bartha, Neil Duggal
OBJECTIVE The goal of this study was to compare the recovery of neuronal metabolism and functional reorganization in the primary motor cortex (M1) between mild and moderate cervical spondylotic myelopathy (CSM) following surgical intervention. METHODS Twenty-eight patients with CSM underwent 3-T MRI scans that included spectroscopy and functional MRI, before surgery and 6 months postsurgery. The classification of severity was based on the modified Japanese Orthopaedic Association questionnaire. Mild and moderate myelopathy were defined by modified Japanese Orthopaedic Association scores > 12 of 18 (n = 15) and 9-12 (n = 13), respectively...
May 2017: Journal of Neurosurgery. Spine
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