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Improved potential quality of intraoperative transcranial motor-evoked potentials by navigated electrode placement compared to the conventional ten-twenty system

Intraoperative neurophysiological monitoring of transcranial motor-evoked potentials (tcMEPs) may fail to produce a serviceable signal due to displacements by mass lesions. We hypothesize that navigated placement of stimulation electrodes yields superior potential quality for tcMEPs compared to the...

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Autores principales: Wagner, Arthur, Ille, Sebastian, Liesenhoff, Caspar, Aftahy, Kaywan, Meyer, Bernhard, Krieg, Sandro M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8827394/
https://www.ncbi.nlm.nih.gov/pubmed/34043110
http://dx.doi.org/10.1007/s10143-021-01568-4
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author Wagner, Arthur
Ille, Sebastian
Liesenhoff, Caspar
Aftahy, Kaywan
Meyer, Bernhard
Krieg, Sandro M.
author_facet Wagner, Arthur
Ille, Sebastian
Liesenhoff, Caspar
Aftahy, Kaywan
Meyer, Bernhard
Krieg, Sandro M.
author_sort Wagner, Arthur
collection PubMed
description Intraoperative neurophysiological monitoring of transcranial motor-evoked potentials (tcMEPs) may fail to produce a serviceable signal due to displacements by mass lesions. We hypothesize that navigated placement of stimulation electrodes yields superior potential quality for tcMEPs compared to the conventional 10–20 placement. We prospectively included patients undergoing elective cranial surgery with intraoperative monitoring of tcMEPs. In addition to electrode placement as per the 10–20 system, an electrode pair was placed at a location corresponding to the hand knob area of the primary motor cortex (M1) for every patient, localized by a navigation system during surgical setup. Twenty-five patients undergoing elective navigated surgery for intracranial tumors (n = 23; 92%) or vascular lesions (n = 2; 8%) under intraoperative monitoring of tcMEPs were included between June and August 2019 at our department. Stimulation and recording of tcMEPs was successful in every case for the navigated electrode pair, while stimulation by 10–20 electrodes did not yield baseline tcMEPs in two cases (8%) with anatomical displacement of the M1. While there was no significant difference between baseline amplitudes, mean potential quality decreased significantly by 88.3 µV (− 13.5%) for the 10–20 electrodes (p = 0.004) after durotomy, unlike for the navigated electrodes (− 28.6 µV [− 3.1%]; p = 0.055). For patients with an anatomically displaced M1, the navigated tcMEPs declined significantly less after durotomy (− 3.6% vs. 10–20: − 23.3%; p = 0.038). Navigated placement of tcMEP electrodes accounts for interindividual anatomical variance and pathological dislocation of the M1, yielding more consistent potentials and reliable potential quality.
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spelling pubmed-88273942022-02-22 Improved potential quality of intraoperative transcranial motor-evoked potentials by navigated electrode placement compared to the conventional ten-twenty system Wagner, Arthur Ille, Sebastian Liesenhoff, Caspar Aftahy, Kaywan Meyer, Bernhard Krieg, Sandro M. Neurosurg Rev Original Article Intraoperative neurophysiological monitoring of transcranial motor-evoked potentials (tcMEPs) may fail to produce a serviceable signal due to displacements by mass lesions. We hypothesize that navigated placement of stimulation electrodes yields superior potential quality for tcMEPs compared to the conventional 10–20 placement. We prospectively included patients undergoing elective cranial surgery with intraoperative monitoring of tcMEPs. In addition to electrode placement as per the 10–20 system, an electrode pair was placed at a location corresponding to the hand knob area of the primary motor cortex (M1) for every patient, localized by a navigation system during surgical setup. Twenty-five patients undergoing elective navigated surgery for intracranial tumors (n = 23; 92%) or vascular lesions (n = 2; 8%) under intraoperative monitoring of tcMEPs were included between June and August 2019 at our department. Stimulation and recording of tcMEPs was successful in every case for the navigated electrode pair, while stimulation by 10–20 electrodes did not yield baseline tcMEPs in two cases (8%) with anatomical displacement of the M1. While there was no significant difference between baseline amplitudes, mean potential quality decreased significantly by 88.3 µV (− 13.5%) for the 10–20 electrodes (p = 0.004) after durotomy, unlike for the navigated electrodes (− 28.6 µV [− 3.1%]; p = 0.055). For patients with an anatomically displaced M1, the navigated tcMEPs declined significantly less after durotomy (− 3.6% vs. 10–20: − 23.3%; p = 0.038). Navigated placement of tcMEP electrodes accounts for interindividual anatomical variance and pathological dislocation of the M1, yielding more consistent potentials and reliable potential quality. Springer Berlin Heidelberg 2021-05-27 2022 /pmc/articles/PMC8827394/ /pubmed/34043110 http://dx.doi.org/10.1007/s10143-021-01568-4 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
Wagner, Arthur
Ille, Sebastian
Liesenhoff, Caspar
Aftahy, Kaywan
Meyer, Bernhard
Krieg, Sandro M.
Improved potential quality of intraoperative transcranial motor-evoked potentials by navigated electrode placement compared to the conventional ten-twenty system
title Improved potential quality of intraoperative transcranial motor-evoked potentials by navigated electrode placement compared to the conventional ten-twenty system
title_full Improved potential quality of intraoperative transcranial motor-evoked potentials by navigated electrode placement compared to the conventional ten-twenty system
title_fullStr Improved potential quality of intraoperative transcranial motor-evoked potentials by navigated electrode placement compared to the conventional ten-twenty system
title_full_unstemmed Improved potential quality of intraoperative transcranial motor-evoked potentials by navigated electrode placement compared to the conventional ten-twenty system
title_short Improved potential quality of intraoperative transcranial motor-evoked potentials by navigated electrode placement compared to the conventional ten-twenty system
title_sort improved potential quality of intraoperative transcranial motor-evoked potentials by navigated electrode placement compared to the conventional ten-twenty system
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8827394/
https://www.ncbi.nlm.nih.gov/pubmed/34043110
http://dx.doi.org/10.1007/s10143-021-01568-4
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