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通过术后导航的横磁刺激运动测绘来评估术后运动功能.

Thomas Eibl1, Adrian Liebert1, Leonard Ritter1

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脑瘤手术是对大脑瘤的手术.扩散张力成像的成像方法运动器功能 运动器功能导航的跨脑磁刺激 导航的跨脑磁刺激神经瘤学神经瘤学

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科学领域:

  • 神经外科 神经外科
  • 神经生理学 神经生理学
  • 医疗成像医学成像

背景情况:

  • 导航式横磁刺激 (nTMS) 用于在脑瘤手术中进行手术前的运动映射.
  • 术后的nTMS用于评估皮质脊柱管 (CST) 损伤和功能结果的研究较少.

研究的目的:

  • 评估术后nTMS运动映射在预测脑瘤切除后功能恢复中的实用性.
  • 用nTMS评估与手术相关的CST损伤和功能结果.

主要方法:

  • 对接受脑瘤切除手术前和后使用nTMS的患者的回顾性评估.
  • 纳入标准:手术后运动缺陷或手术前缺陷没有显著改善 (MRC ≤3/5).
  • 通过扩散张力成像 (DTI) 进行CST可视化;主要结果:MRC ≥4/5运动状态在3个月.

主要成果:

  • 包括17名患者;82.4%有可记录的运动唤起潜力 (MEP).
  • 运动恢复的正预测值 (PPV) 为90.5%;负预测值 (NPV) 为38.5%.
  • 手术后手术后半球运动值增加 (p=0.008);在对侧半球稳定 (p=0.11).

结论:

  • 手术后的nTMS运动映射显示了预测暂时运动缺陷的功能恢复的潜力.
  • 当MEP可以在术后引起时,观察到显著的运动改善.
  • 需要进一步的研究来证实nTMS在功能恢复方面的预测价值.