Monopolar 250–500 Hz language mapping: Results of 41 patients
•Monopolar mapping is effective for cortical and subcortical language areas.•250–500 Hz stimulation parameters are adequate and safe for speech testing.•It may improve resection rate of infiltrating tumor areas involving the speech area. To determine whether high-frequency 250–500 Hz monopolar stimu...
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| Published in | Clinical neurophysiology practice Vol. 4; pp. 1 - 8 |
|---|---|
| Main Authors | , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Netherlands
Elsevier B.V
01.01.2019
Elsevier |
| Subjects | |
| Online Access | Get full text |
| ISSN | 2467-981X 2467-981X |
| DOI | 10.1016/j.cnp.2018.11.002 |
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| Abstract | •Monopolar mapping is effective for cortical and subcortical language areas.•250–500 Hz stimulation parameters are adequate and safe for speech testing.•It may improve resection rate of infiltrating tumor areas involving the speech area.
To determine whether high-frequency 250–500 Hz monopolar stimulation is effective for mapping cortical and subcortical language structures during brain tumor resection.
Using high-frequency monopolar stimulation, we mapped the speech areas of 41 awake patients undergoing brain tumor resection in the dominant hemisphere, subject to risk of lesions in the cortical and subcortical speech tracts. Patients were tested for object naming, semantic and other language tasks.
Mapping was positive in 22 out of 41 patients. Nine patients presented clinical worsening immediately after surgery. Only one patient did not recover after the 30-day follow-up. Nineteen patients showed negative mapping for language tracts, none of whom exhibited worsening of symptoms at the final evaluation. The applied method showed 89% sensitivity and 56% specificity rates.
The applied method was effective in identifying cortical and subcortical speech areas during the surgical resection of brain tumors.
Determining whether monopolar high-frequency stimulation is effective for language mapping is important, since it may be very effective in infiltrating tumor areas and nearby edema region. |
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| AbstractList | To determine whether high-frequency 250-500 Hz monopolar stimulation is effective for mapping cortical and subcortical language structures during brain tumor resection.OBJECTIVESTo determine whether high-frequency 250-500 Hz monopolar stimulation is effective for mapping cortical and subcortical language structures during brain tumor resection.Using high-frequency monopolar stimulation, we mapped the speech areas of 41 awake patients undergoing brain tumor resection in the dominant hemisphere, subject to risk of lesions in the cortical and subcortical speech tracts. Patients were tested for object naming, semantic and other language tasks.METHODSUsing high-frequency monopolar stimulation, we mapped the speech areas of 41 awake patients undergoing brain tumor resection in the dominant hemisphere, subject to risk of lesions in the cortical and subcortical speech tracts. Patients were tested for object naming, semantic and other language tasks.Mapping was positive in 22 out of 41 patients. Nine patients presented clinical worsening immediately after surgery. Only one patient did not recover after the 30-day follow-up. Nineteen patients showed negative mapping for language tracts, none of whom exhibited worsening of symptoms at the final evaluation. The applied method showed 89% sensitivity and 56% specificity rates.RESULTSMapping was positive in 22 out of 41 patients. Nine patients presented clinical worsening immediately after surgery. Only one patient did not recover after the 30-day follow-up. Nineteen patients showed negative mapping for language tracts, none of whom exhibited worsening of symptoms at the final evaluation. The applied method showed 89% sensitivity and 56% specificity rates.The applied method was effective in identifying cortical and subcortical speech areas during the surgical resection of brain tumors.CONCLUSIONSThe applied method was effective in identifying cortical and subcortical speech areas during the surgical resection of brain tumors.Determining whether monopolar high-frequency stimulation is effective for language mapping is important, since it may be very effective in infiltrating tumor areas and nearby edema region.SIGNIFICANCEDetermining whether monopolar high-frequency stimulation is effective for language mapping is important, since it may be very effective in infiltrating tumor areas and nearby edema region. • Monopolar mapping is effective for cortical and subcortical language areas. • 250–500 Hz stimulation parameters are adequate and safe for speech testing. • It may improve resection rate of infiltrating tumor areas involving the speech area. Objectives: To determine whether high-frequency 250–500 Hz monopolar stimulation is effective for mapping cortical and subcortical language structures during brain tumor resection. Methods: Using high-frequency monopolar stimulation, we mapped the speech areas of 41 awake patients undergoing brain tumor resection in the dominant hemisphere, subject to risk of lesions in the cortical and subcortical speech tracts. Patients were tested for object naming, semantic and other language tasks. Results: Mapping was positive in 22 out of 41 patients. Nine patients presented clinical worsening immediately after surgery. Only one patient did not recover after the 30-day follow-up. Nineteen patients showed negative mapping for language tracts, none of whom exhibited worsening of symptoms at the final evaluation. The applied method showed 89% sensitivity and 56% specificity rates. Conclusions: The applied method was effective in identifying cortical and subcortical speech areas during the surgical resection of brain tumors. Significance: Determining whether monopolar high-frequency stimulation is effective for language mapping is important, since it may be very effective in infiltrating tumor areas and nearby edema region. Keywords: Awake craniotomy, Cortical stimulation, Glioma, Language mapping, Motor evoked potentials, Subcortical mapping, Motor mapping To determine whether high-frequency 250-500 Hz monopolar stimulation is effective for mapping cortical and subcortical language structures during brain tumor resection. Using high-frequency monopolar stimulation, we mapped the speech areas of 41 awake patients undergoing brain tumor resection in the dominant hemisphere, subject to risk of lesions in the cortical and subcortical speech tracts. Patients were tested for object naming, semantic and other language tasks. Mapping was positive in 22 out of 41 patients. Nine patients presented clinical worsening immediately after surgery. Only one patient did not recover after the 30-day follow-up. Nineteen patients showed negative mapping for language tracts, none of whom exhibited worsening of symptoms at the final evaluation. The applied method showed 89% sensitivity and 56% specificity rates. The applied method was effective in identifying cortical and subcortical speech areas during the surgical resection of brain tumors. Determining whether monopolar high-frequency stimulation is effective for language mapping is important, since it may be very effective in infiltrating tumor areas and nearby edema region. •Monopolar mapping is effective for cortical and subcortical language areas.•250–500 Hz stimulation parameters are adequate and safe for speech testing.•It may improve resection rate of infiltrating tumor areas involving the speech area. To determine whether high-frequency 250–500 Hz monopolar stimulation is effective for mapping cortical and subcortical language structures during brain tumor resection. Using high-frequency monopolar stimulation, we mapped the speech areas of 41 awake patients undergoing brain tumor resection in the dominant hemisphere, subject to risk of lesions in the cortical and subcortical speech tracts. Patients were tested for object naming, semantic and other language tasks. Mapping was positive in 22 out of 41 patients. Nine patients presented clinical worsening immediately after surgery. Only one patient did not recover after the 30-day follow-up. Nineteen patients showed negative mapping for language tracts, none of whom exhibited worsening of symptoms at the final evaluation. The applied method showed 89% sensitivity and 56% specificity rates. The applied method was effective in identifying cortical and subcortical speech areas during the surgical resection of brain tumors. Determining whether monopolar high-frequency stimulation is effective for language mapping is important, since it may be very effective in infiltrating tumor areas and nearby edema region. |
| Author | de Aguiar, P.H.P. Vieira, V.G. Maldaun, M.V.C. Verst, S.M. Joaquim, M.A.S. Sucena, A.B.C. |
| AuthorAffiliation | b Neurology at Catholic Pontifica University of São Paulo, Department of Internal Medicine, Rua David Ben Gurion, 1077 apto 12, São Paulo, SP 05634-001, Brazil d Department of Anesthesiology, Sirio Libanês Hospital, Rua Bagé, 97 apto 141, São Paulo, SP, Brazil a Brain Spine Neurophysiology, Intraoperative Neurophysiology at Hospital Sirio Libanês, Rua Barão de Teffé, 1000 sala 55 Jundiai, São Paulo, SP 13208-761, Brazil c Sirio Libanês Hospital, Rua Adma Jafet, 50 cj 24, São Paulo, SP 01425-001, Brazil f Sirio Libanês Hospital, Rua Barata Ribeiro, 414, cj 63, São Paulo, SP 01308-000, Brazil e Brain Spine Neurophysiology, Rua Dr. Samuel de Castro Neves, 148 apto 154, São Paulo 04726-240, Brazil |
| AuthorAffiliation_xml | – name: c Sirio Libanês Hospital, Rua Adma Jafet, 50 cj 24, São Paulo, SP 01425-001, Brazil – name: e Brain Spine Neurophysiology, Rua Dr. Samuel de Castro Neves, 148 apto 154, São Paulo 04726-240, Brazil – name: b Neurology at Catholic Pontifica University of São Paulo, Department of Internal Medicine, Rua David Ben Gurion, 1077 apto 12, São Paulo, SP 05634-001, Brazil – name: a Brain Spine Neurophysiology, Intraoperative Neurophysiology at Hospital Sirio Libanês, Rua Barão de Teffé, 1000 sala 55 Jundiai, São Paulo, SP 13208-761, Brazil – name: f Sirio Libanês Hospital, Rua Barata Ribeiro, 414, cj 63, São Paulo, SP 01308-000, Brazil – name: d Department of Anesthesiology, Sirio Libanês Hospital, Rua Bagé, 97 apto 141, São Paulo, SP, Brazil |
| Author_xml | – sequence: 1 givenname: S.M. orcidid: 0000-0002-8553-1761 surname: Verst fullname: Verst, S.M. email: silvia@brainspine.com.br organization: Brain Spine Neurophysiology, Intraoperative Neurophysiology at Hospital Sirio Libanês, Rua Barão de Teffé, 1000 sala 55 Jundiai, São Paulo, SP 13208-761, Brazil – sequence: 2 givenname: P.H.P. surname: de Aguiar fullname: de Aguiar, P.H.P. organization: Neurology at Catholic Pontifica University of São Paulo, Department of Internal Medicine, Rua David Ben Gurion, 1077 apto 12, São Paulo, SP 05634-001, Brazil – sequence: 3 givenname: M.A.S. surname: Joaquim fullname: Joaquim, M.A.S. organization: Sirio Libanês Hospital, Rua Adma Jafet, 50 cj 24, São Paulo, SP 01425-001, Brazil – sequence: 4 givenname: V.G. surname: Vieira fullname: Vieira, V.G. organization: Department of Anesthesiology, Sirio Libanês Hospital, Rua Bagé, 97 apto 141, São Paulo, SP, Brazil – sequence: 5 givenname: A.B.C. surname: Sucena fullname: Sucena, A.B.C. organization: Brain Spine Neurophysiology, Rua Dr. Samuel de Castro Neves, 148 apto 154, São Paulo 04726-240, Brazil – sequence: 6 givenname: M.V.C. surname: Maldaun fullname: Maldaun, M.V.C. organization: Sirio Libanês Hospital, Rua Barata Ribeiro, 414, cj 63, São Paulo, SP 01308-000, Brazil |
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| Keywords | Subcortical mapping Motor mapping Awake craniotomy Glioma Cortical stimulation Motor evoked potentials Language mapping |
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| Snippet | •Monopolar mapping is effective for cortical and subcortical language areas.•250–500 Hz stimulation parameters are adequate and safe for speech testing.•It may... To determine whether high-frequency 250-500 Hz monopolar stimulation is effective for mapping cortical and subcortical language structures during brain tumor... • Monopolar mapping is effective for cortical and subcortical language areas. • 250–500 Hz stimulation parameters are adequate and safe for speech testing. •... Objectives: To determine whether high-frequency 250–500 Hz monopolar stimulation is effective for mapping cortical and subcortical language structures during... |
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| SubjectTerms | Awake craniotomy Clinical and Cortical stimulation Glioma Language mapping Motor evoked potentials Motor mapping Subcortical mapping |
| Title | Monopolar 250–500 Hz language mapping: Results of 41 patients |
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