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Motor tract monitoring

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https://www.readbyqxmd.com/read/28529055/intraoperative-mapping-and-monitoring-of-the-pyramidal-tract-using-endoscopic-depth-electrodes
#1
Yukinori Akiyama, Shunya Ohtaki, Katsuya Komatsu, Kentaro Toyama, Rei Enatsu, Takeshi Mikami, Masahiko Wanibuchi, Nobuhiro Mikuni
OBJECTIVE: To evaluate motor function during neuroendoscopic resectioning of deep-seated brain tumors using endoscopically guided depth electrodes. METHODS: For 12 cases of thalamic tumors including high-grade gliomas, germinomas, and malignant lymphomas, depth electrodes were inserted using endoscopic guides between the tumor and the pyramidal tract in the thalamus. Motor evoked potentials (MEPs) were continuously recorded during neuroendoscopic resectioning of the tumors...
May 18, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28524753/continuous-mapping-of-the-corticospinal-tracts-in-intramedullary-spinal-cord-tumor-surgery-using-an-electrified-ultrasonic-aspirator
#2
Ori Barzilai, Zvi Lidar, Shlomi Constantini, Khalil Salame, Yifat Bitan-Talmor, Akiva Korn
Intramedullary spinal cord tumors (IMSCTs) represent a rare entity, accounting for 4%-10% of all central nervous system tumors. Microsurgical resection of IMSCTs is currently considered the primary treatment modality. Intraoperative neurophysiological monitoring (IONM) has been shown to aid in maximizing tumor resection and minimizing neurological morbidity, consequently improving patient outcome. The gold standard for IONM to date is multimodality monitoring, consisting of both somatosensory evoked potentials, as well as muscle-based transcranial electric motor evoked potentials (tcMEPs)...
May 19, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28464582/-clinical-useness-of-multimodal-techniques-in-microsurgical-resection-of-cerebral-arteriovenous-malformation
#3
Y Y Zhang, J L Jiang, Z H Sun, C Wu, W Shi, Z Xue, S Y Feng, X G Yu
Objective: To explore the clinical useness of intraoperative functional neuronavigation and fluorescent indocyanine green(ICG) angiography as well as electrophysiological evaluation during microsurgical resection of cerebral arteriovenous malformations (AVM). Methods: A series of 42 consecutive cases with AVM underwent microsurgery by intraoperative functional neuronavigation at Department of Neurosurgery of People's Liberation Army General Hospital from January 2009 to February 2015 were retrospectively analyzed...
May 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28392455/the-effect-of-sparkling-water-on-intraluminal-formulation-behaviour-and-systemic-drug-performance
#4
Jens Van Den Abeele, Joachim Brouwers, Eveline Deloose, Jan Tack, Patrick Augustijns
In the context of mediating intra- and inter-individual variability in systemic drug exposure after oral drug administration, this small-scale, crossover study aimed to investigate the effect of drug intake with sparkling water on fasted state gastric motor function and subsequent (variability in) intraluminal and systemic drug disposition. For this purpose, healthy human volunteers were asked to ingest a conventional paracetamol tablet with either tap or sparkling water, after which antroduodenal motility as well as intraluminal and systemic drug disposition were monitored as a function of time...
April 6, 2017: Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28362960/ipsilateral-motor-innervation-discovered-incidentally-on-intraoperative-monitoring-a-case-report
#5
Jerry Ku, Daniel Mendelsohn, Jason Chew, Jason Shewchuk, Charles Dong, Ryojo Akagami
BACKGROUND AND IMPORTANCE: Lesions in the corticospinal tract above the decussation at the medullary pyramids almost universally produce contralateral deficits. Rare cases of supratentorial lesions causing ipsilateral motor deficits have been reported previously, but only ever found secondary to stroke or congenital pyramidal tract malformations. CLINICAL PRESENTATION: Herein, we report a case of ipsilateral corticospinal tract innervation discovered incidentally with intraoperative monitoring during a microsurgical resection of a vestibular schwannoma...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28341235/physiological-markers-of-motor-inhibition-during-human-behavior
#6
REVIEW
Julie Duque, Ian Greenhouse, Ludovica Labruna, Richard B Ivry
Transcranial magnetic stimulation (TMS) studies in humans have shown that many behaviors engage processes that suppress excitability within the corticospinal tract. Inhibition of the motor output pathway has been extensively studied in the context of action stopping, where a planned movement needs to be abruptly aborted. Recent TMS work has also revealed markers of motor inhibition during the preparation of movement. Here, we review the evidence for motor inhibition during action stopping and action preparation, focusing on studies that have used TMS to monitor changes in the excitability of the corticospinal pathway...
April 2017: Trends in Neurosciences
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
REVIEW
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
#16
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
#17
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
#18
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
#19
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
#20
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
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