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Motor tract monitoring

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https://www.readbyqxmd.com/read/28327942/evaluation-of-the-high-frequency-monopolar-stimulation-technique-for-mapping-and-monitoring-the-corticospinal-tract-in-patients-with-supratentorial-gliomas-a-proposal-for-intraoperative-management-based-on-neurophysiological-data-analysis-in-a-series-of-ninety
#1
Gerard Plans, Isabel Fernández-Conejero, Xavier Rifà-Ros, Alejandro Fernández-Coello, Aleix Rosselló, Andreu Gabarrós
BACKGROUND: Intraoperative identification and preservation of the corticospinal tract is often necessary for glioma resection. OBJECTIVE: To make a proposal for intraoperative management with the high-frequency monopolar stimulation technique for monitoring the corticospinal tract. METHODS: Ninety-two patients operated on with the assistance of the high-frequency monopolar stimulation. Clinical and neurophysiological data have been related with the motor status at 3 months to establish prognostic factors of motor deterioration...
January 13, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28293701/diffusion-tensor-imaging-as-a-prognostic-biomarker-for-motor-recovery-and-rehabilitation-after-stroke
#2
REVIEW
Josep Puig, Gerard Blasco, Gottfried Schlaug, Cathy M Stinear, Pepus Daunis-I-Estadella, Carles Biarnes, Jaume Figueras, Joaquín Serena, Maria Hernández-Pérez, Angel Alberich-Bayarri, Mar Castellanos, David S Liebeskind, Andrew M Demchuk, Bijoy K Menon, Götz Thomalla, Kambiz Nael, Max Wintermark, Salvador Pedraza
PURPOSE: Despite improved acute treatment and new tools to facilitate recovery, most patients have motor deficits after stroke, often causing disability. However, motor impairment varies considerably among patients, and recovery in the acute/subacute phase is difficult to predict using clinical measures alone, particularly in severely impaired patients. Accurate early prediction of recovery would help rationalize rehabilitation goals and improve the design of trials testing strategies to facilitate recovery...
March 14, 2017: Neuroradiology
https://www.readbyqxmd.com/read/28291403/a-rat-model-of-chronic-syringomyelia-induced-by-epidural-compression-of-the-lumbar-spinal-cord
#3
Ji Yeoun Lee, Shin Won Kim, Saet Pyoul Kim, Hyeonjin Kim, Jung-Eun Cheon, Seung-Ki Kim, Sun Ha Paek, Dachling Pang, Kyu-Chang Wang
OBJECTIVE There has been no established animal model of syringomyelia associated with lumbosacral spinal lipoma. The research on the pathophysiology of syringomyelia has been focused on Chiari malformation, trauma, and inflammation. To understand the pathophysiology of syringomyelia associated with occult spinal dysraphism, a novel animal model of syringomyelia induced by chronic mechanical compression of the lumbar spinal cord was created. METHODS The model was made by epidural injection of highly concentrated paste-like kaolin solution through windows created by partial laminectomy of L-1 and L-5 vertebrae...
February 17, 2017: Journal of Neurosurgery. Spine
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
#4
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/28243591/transcranial-motor-evoked-potentials-during-spinal-deformity-corrections-safety-efficacy-limitations-and-the-role-of-a-checklist
#5
Shankar Acharya, Nagendra Palukuri, Pravin Gupta, Manish Kohli
INTRODUCTION: Intraoperative neuromonitoring (IONM) has become a standard of care in spinal deformity surgeries to minimize the incidence of new onset neurological deficit. Stagnara wake up test and ankle clonus test are the oldest techniques described for spinal cord monitoring, but they cannot be solely relied upon as a neuromonitoring modality. Somatosensory evoked potentials monitor only dorsal tracts and give high false positive and negative alerts. Transcranial motor evoked potentials (TcMEPs) monitor the more useful motor pathways...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28185224/white-matter-microstructure-and-subcortical-gray-matter-structure-volumes-in-aspartylglucosaminuria-a-5-year-follow-up-brain-mri-study-of-an-adolescent-with-aspartylglucosaminuria-and-his-healthy-twin-brother
#6
Anna Tokola, Nina Brandstack, Antti Hakkarainen, Eero Salli, Laura Åberg, Taina Autti
OBJECTIVE: Aspartylglucosaminuria is an inherited, lysosomal storage disease causing progressive decline in cognitive and motor functions. The aim of this study was to evaluate volumes of subcortical gray matter structures and white matter microstructure in aspartylglucosaminuria in adolescence in a longitudinal study for the first time. METHODS: A boy with aspartylglucosaminuria and his healthy twin brother were imaged twice with a 3.0 T MRI scanner at the ages of 10 and 15 years...
February 10, 2017: JIMD Reports
https://www.readbyqxmd.com/read/28161015/-electrophysiological-testing-in-spinal-cord-tumors
#7
REVIEW
N André-Obadia, F Mauguière
Evoked potentials (EPs) are useful to evaluate the functional impairment of motor and somatosensory pathways in spinal cord tumors. Conduction through pyramidal tracts is evaluated by motor EPs (MEPs) elicited by transcranial stimulation, magnetic for awake patients or electric in the operating room. Somatosensory EPs (SEPs) and laser EPs (LEPs) are complementary procedures to explore conduction in dorsal columns and spinothalamic tracts, respectively. MEPs as well as SEPs show conduction abnormalities in about 60% of cases with a sensitivity that increases up to 70% when both procedures are carried out...
February 1, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28120010/thirty-years-of-transcranial-magnetic-stimulation-where-do-we-stand
#8
REVIEW
Ulf Ziemann
Transcranial magnetic stimulation (TMS) has been first described 30 years ago, and since then has gained enormous attention by neurologists, psychiatrists, neurosurgeons, clinical neurophysiologists, psychologists, and neuroscientist alike. In the early days, it was primarily used to test integrity of the corticospinal tract. Beyond further developments of TMS in diagnostics, mapping and monitoring of the motor system, major other applications expanded into using TMS as research tool in the cognitive neurosciences, and as therapeutic tool in neurological and psychiatric disease by virtue of inducing long-term change in excitability and connectivity of the stimulated brain networks...
April 2017: Experimental Brain Research. Experimentelle Hirnforschung. Expérimentation Cérébrale
https://www.readbyqxmd.com/read/28045853/intraoperative-neuromonitoring-and-alarm-criteria-for-judging-mep-responses-to-transcranial-electric-stimulation-the-threshold-level-method
#9
Blair Calancie
The motor evoked potential (MEP) is used in the operating room to gauge-and ultimately protect-the functional integrity of the corticospinal tract (CST). However, there is no consensus as to how to best interpret the MEP for maximizing its sensitivity and specificity to CST compromise. The most common way is to use criteria associated with response magnitude (response amplitude; waveform complexity, etc.). With this approach, should an MEP in response to a fixed stimulus intensity diminish below some predetermined cutoff, suggesting CST dysfunction, then the surgical team is warned...
January 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/27994536/a-novel-technique-for-region-and-linguistic-specific-ntms-based-dti-fiber-tracking-of-language-pathways-in-brain-tumor-patients
#10
Giovanni Raffa, Ina Bährend, Heike Schneider, Katharina Faust, Antonino Germanò, Peter Vajkoczy, Thomas Picht
Navigated transcranial magnetic stimulation (nTMS) has recently been introduced as a non-invasive tool for functional mapping of cortical language areas prior to surgery. It correlates well with intraoperative neurophysiological monitoring (IONM) findings, allowing defining the best surgical strategy to preserve cortical language areas during surgery for language-eloquent tumors. Nevertheless, nTMS allows only for cortical mapping and postoperative language deficits are often caused by injury to subcortical language pathways...
2016: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/27987035/distant-recurrences-limit-the-survival-of-patients-with-thalamic-high-grade-gliomas-after-successful-resection
#11
Ryuta Saito, Toshihiro Kumabe, Masayuki Kanamori, Yukihiko Sonoda, Teiji Tominaga
The indications of surgery for thalamic high-grade gliomas are not well established. The present study investigated the outcome of 21 patients treated by surgery and reports the high incidence of distant recurrences including disseminations after successful removal. Twenty-one patients with thalamic high-grade gliomas not invading the pyramidal tract or midbrain underwent cytoreductive surgery at our institute from June 1997 to August 2015. Surgery was performed with the aid of a neuronavigation system, electrophysiological monitoring, and fluorescence navigation...
December 17, 2016: Neurosurgical Review
https://www.readbyqxmd.com/read/27862250/prenatal-myelomeningocele-repair-do-bladders-better
#12
Maya Horst, Luca Mazzone, Thomas Schraner, Christine Bodmer, Ueli Möhrlen, Martin Meuli, Rita Gobet
AIMS: Prenatal myelomeningocele (MMC) repair has been proven to significantly reduce the need for hydrocephalus shunting and improve lower-extremity motor outcomes. The aim of this study was to evaluate the effect of prenatal MMC repair on the urological outcome. METHODS: All patients who underwent fetal MMC repair at our institution are followed prospectively. Assessments include medical history, renal and bladder ultrasound, voiding cystourethrogram and urodynamic study, need for clean intermittent catheterization (CIC) and anticholinergics, and the occurrence of urinary tract infections (UTI)...
November 15, 2016: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/27751944/hippocampal-to-basal-forebrain-transport-of-mn-2-is-impaired-by-deletion-of-klc1-a-subunit-of-the-conventional-kinesin-microtubule-based-motor
#13
Christopher S Medina, Octavian Biris, Tomas L Falzone, Xiaowei Zhang, Amber J Zimmerman, Elaine L Bearer
Microtubule-based motors carry cargo back and forth between the synaptic region and the cell body. Defects in axonal transport result in peripheral neuropathies, some of which are caused by mutations in KIF5A, a gene encoding one of the heavy chain isoforms of conventional kinesin-1. Some mutations in KIF5A also cause severe central nervous system defects in humans. While transport dynamics in the peripheral nervous system have been well characterized experimentally, transport in the central nervous system is less experimentally accessible and until now not well described...
January 15, 2017: NeuroImage
https://www.readbyqxmd.com/read/27662531/effects-of-transcranial-stimulating-electrode-montages-over-the-head-for-lower-extremity-transcranial-motor-evoked-potential-monitoring
#14
Ryosuke Tomio, Takenori Akiyama, Takayuki Ohira, Kazunari Yoshida
OBJECTIVE The aim of this study was to determine the most effective electrode montage to elicit lower-extremity transcranial motor evoked potentials (LE-tMEPs) using a minimum stimulation current. METHODS A realistic 3D head model was created from T1-weighted images. Finite element methods were used to visualize the electric field in the brain, which was generated by transcranial electrical stimulation via 4 electrode montage models. The stimulation threshold level of LE-tMEPs in 52 patients was also studied in a practical clinical setting to determine the effects of each electrode montage...
September 23, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27521196/intraoperative-monitoring-recent-advances-in-motor-evoked-potentials
#15
REVIEW
Antoun Koht, Tod B Sloan
Advances in electrophysiological monitoring have improved the ability of surgeons to make decisions and minimize the risks of complications during surgery and interventional procedures when the central nervous system (CNS) is at risk. Individual techniques have become important for identifying or mapping the location and pathway of critical neural structures. These techniques are also used to monitor the progress of procedures to augment surgical and physiologic management so as to reduce the risk of CNS injury...
September 2016: Anesthesiology Clinics
https://www.readbyqxmd.com/read/27446526/usefulness-of-motor-evoked-potentials-monitoring-for-neurosurgical-treatment-of-an-unusual-distal-anterior-choroidal-artery-aneurysm
#16
Charles Champeaux, Vincent Jecko, Sandrine Eimer, Guillaume Penchet
A 35 years old woman presented with an acute meningeal syndrome following an intra ventricular haemorrhage without subarachnoid haemorrhage. The angiography demonstrated a 6 mm partially thrombosed saccular aneurysm at the plexal point of the right anterior choroidal artery (AChoA). It was surgically approached inside the ventricle through a trans-temporal corticotomy. The aneurysm was excised after distal exclusion of the feeding artery under motor-evoked potentials monitoring. Of the 19 cases of distal AChoA aneurysm neurosurgical treatment, this is the only one performed under electrophysiology monitoring, a simple and safe method to detect and prevent motor tract ischemia...
July 2016: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/27423016/magnetoencephalography-guided-surgery-in-frontal-lobe-epilepsy-using-neuronavigation-and-intraoperative-mr-imaging
#17
Björn Sommer, Karl Roessler, Stefan Rampp, Hajo M Hamer, Ingmar Blumcke, Hermann Stefan, Michael Buchfelder
BACKGROUND: Especially in hidden lesions causing drug-resistant frontal lobe epilepsy (FLE), the localization of the epileptic zone EZ can be a challenge. Magnetoencephalography (MEG) can raise the chances for localization of the (EZ) in combination with electroencephalography (EEG). We investigated the impact of MEG-guided epilepsy surgery with the aid of neuronavigation and intraoperative MR imaging (iopMRI) on seizure outcome of FLE patients. METHODS: Twenty-eight patients (15 females, 13 males; mean age 31...
October 2016: Epilepsy Research
https://www.readbyqxmd.com/read/27417041/abnormal-corticospinal-tract-function-and-motor-cortex-excitability-in-non-ataxic-sca2-mutation-carriers-a-tms-study
#18
Luis Velázquez-Pérez, Roberto Rodríguez-Labrada, Reidenis Torres-Vega, Jacqueline Medrano Montero, Yaimeé Vázquez-Mojena, Georg Auburger, Ulf Ziemann
OBJECTIVE: To evaluate if the corticospinal tract is affected in the prodromal stage of spinocerebellar ataxia type 2 (SCA2), prior to development of the cerebellar syndrome. METHODS: A cross-sectional study was conducted in 37 non-ataxic SCA2 mutation carriers and in age- and sex-matched healthy controls. All subjects underwent clinical assessment and transcranial magnetic stimulation to determine corticospinal tract integrity to the right abductor pollicis brevis and tibialis anterior muscles...
August 2016: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/27399442/163%C3%A2-microstructural-mri-quantifies-tract-specific-injury-and-correlates-with-global-disability-and-focal-neurological-deficits-in-degenerative-cervical-myelopathy
#19
Allan R Martin, Benjamin De Leener, Julien Cohen-Adad, Izabela Aleksanderek, David W Cadotte, Sukhvinder Kalsi-Ryan, Lindsay Tetreault, Adrian Crawley, Howard J Ginsberg, Michael G Fehlings
INTRODUCTION: Diffusion tensor imaging (DTI), magnetization transfer (MT), and T2*-weighted imaging measure aspects of spinal cord microstructure. This study investigates if these techniques can quantify injury to individual white matter (WM) tracts and correlate with focal neurological impairments in degenerative cervical myelopathy (DCM). METHODS: Fifty-seven DCM patients (age 56.7; 61% male; 32 mild, 16 moderate, 9 severe) underwent comprehensive clinical assessments and multimodal MRI (3T GE)...
August 2016: Neurosurgery
https://www.readbyqxmd.com/read/27293965/intraoperative-neurophysiological-monitoring-for-endoscopic-endonasal-approaches-to-the-skull-base-a-technical-guide
#20
REVIEW
Harminder Singh, Richard W Vogel, Robert M Lober, Adam T Doan, Craig I Matsumoto, Tyler J Kenning, James J Evans
Intraoperative neurophysiological monitoring during endoscopic, endonasal approaches to the skull base is both feasible and safe. Numerous reports have recently emerged from the literature evaluating the efficacy of different neuromonitoring tests during endonasal procedures, making them relatively well-studied. The authors report on a comprehensive, multimodality approach to monitoring the functional integrity of at risk nervous system structures, including the cerebral cortex, brainstem, cranial nerves, corticospinal tract, corticobulbar tract, and the thalamocortical somatosensory system during endonasal surgery of the skull base...
2016: Scientifica
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