脳皮質電位/脳皮質電気刺激による機能局在を行った脳腫瘍の1例  [in Japanese] Combined Functional Mapping using Electrocorticograms and Electrocortical Stimulation for Brain Tumor Resection  [in Japanese]

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Author(s)

Abstract

 脳腫瘍摘出では機能の温存が重要であり, その機能マッピングには覚醒下手術, 頭蓋内電極による脳皮質電気刺激 (ECS) がある. しかし, ECSは痙攣誘発のリスクや痛みなどを伴う. 近年は脳皮質電位 (ECoG) による機能マッピングの報告があり, 特に高周波律動に注目が集まっている. 今回われわれは, 言語野近傍の脳腫瘍患者において, 頭蓋内電極によりECSマッピングとECoG計測を行った. ECoGは60∼120Hzの高周波律動であるhigh Gamma activity (HGA) に着目した. 文字読み課題で約600msec付近に誘発されたHGAはECSマッピングの側頭葉言語野と一致していた. また, HGAは後頭葉から側頭葉-前頭葉言語関連機能ダイナミクスを表していた. 本症例で施行した認知課題ECoGはECSに代わる脳機能マッピング法となる.

  It is practically important to identify and monitor the eloquent brain functions for maximal resection of brain tumors. Although electrocortical stimulation (ECS) with awake craniotomy or implanted subdural electrodes is the gold-standard for brain mapping, it always contains the risks of seizure and pain. Recent studies reported that the electrocorticogram (ECoG) might have great potential to identify language centers by emphasizing high frequency oscillations. We performed detailed functional mapping using ECS and ECoG for a patient with a brain tumor located near the language-related area. We focused on the high frequency components of ECoG between 60 and 120 Hz, the high Gamma activity (HGA) range. HGA induced by a word-reading task appeared around 600 msec after stimulus onset in the posterior language area, which was confirmed by ECS. In addition, HGA clearly delineated functional dynamics related to the reading task from the occipital to the frontal and temporal regions. We believe that ECoG mapping could become an alternative to ECS mapping and awake craniotomy.

Journal

  • Japanese Journal of Neurosurgery

    Japanese Journal of Neurosurgery 22(10), 786-790, 2013-10-20

    The Japanese Congress of Neurological Surgeons

References:  7

Codes

  • NII Article ID (NAID)
    10031191655
  • NII NACSIS-CAT ID (NCID)
    AN10380506
  • Text Lang
    JPN
  • Article Type
    NOT
  • ISSN
    0917950X
  • Data Source
    CJP  J-STAGE 
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