Seidel, Kathleen; Wermelinger, Jonathan; Alvarez-Abut, Pablo; Deletis, Vedran; Raabe, Andreas; Zhang, David; Schucht, Philippe (2024). Cortico-cortical evoked potentials of language tracts in minimally invasive glioma surgery guided by Penfield stimulation. Clinical neurophysiology, 161, pp. 256-267. Elsevier 10.1016/j.clinph.2023.12.136
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OBJECTIVE
We investigated the feasibility of recording cortico-cortical evoked potentials (CCEPs) in patients with low- and high-grade glioma. We compared CCEPs during awake and asleep surgery, as well as those stimulated from the functional Broca area and recorded from the functional Wernicke area (BtW), and vice versa (WtB). We also analyzed CCEP properties according to tumor location, histopathology, and aphasia.
METHODS
We included 20 patients who underwent minimally invasive surgery in an asleep-awake-asleep setting. Strip electrode placement was guided by classical Penfield stimulation of positive language sites and fiber tracking of the arcuate fascicle. CCEPs were elicited with alternating monophasic single pulses of 1.1 Hz frequency and recorded as averaged signals. Intraoperatively, there was no post-processing of the signal.
RESULTS
Ninety-seven CCEPs from 19 patients were analyzed. There was no significant difference in CCEP properties when comparing awake versus asleep, nor BtW versus WtB. CCEP amplitude and latency were affected by tumor location and histopathology. CCEP features after tumor resection correlated with short- and long-term postoperative aphasia.
CONCLUSION
CCEP recordings are feasible during minimally invasive surgery. CCEPs might be surrogate markers for altered connectivity of the language tracts.
SIGNIFICANCE
This study may guide the incorporation of CCEPs into intraoperative neurophysiological monitoring.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurosurgery |
UniBE Contributor: |
Seidel, Kathleen, Wermelinger, Jonathan, Alvarez Abut, Pablo Abel, Raabe, Andreas, Zhang, David Yuzhe, Schucht, Philippe |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1872-8952 |
Publisher: |
Elsevier |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
25 Mar 2024 10:42 |
Last Modified: |
28 Apr 2024 00:17 |
Publisher DOI: |
10.1016/j.clinph.2023.12.136 |
PubMed ID: |
38521679 |
Uncontrolled Keywords: |
Arcuate fascicle Brain mapping Cortico-cortical evoked potentials Glioma Intraoperative neurophysiological monitoring |
BORIS DOI: |
10.48350/194713 |
URI: |
https://boris.unibe.ch/id/eprint/194713 |
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