科研之友
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摘要
Objective: To explore the feasibility and effect of electrocorticography (ECoG) for intraoperative mapping of motor cortex. Methods: Eight patients with brain lesions near motor areas were operated under awake craniotomy from June 2017 to June 2019. The motor-related cortices were detected by intraoperative direct electrical stimulation (DES). The ECoG signals including μ rhythm and slow cortical potential (SCP) were collected intraoperatively and analyzed by wavelet analysis from patients at rest and hand-moving state (grasp and extension motion). The changes of event-related desynchronization (ERD) of different rhythms were analyzed by wavelet analysis before and after hand grasping. The threshold values of μ rhythm, SCP and different pattern recognition in combination were compared by using DES as gold standard . The receiver operating characteristic (ROC) area under the curve (AUC) and the sensitivity and specificity were evaluated. Results: When the threshold of ERD of the μ rhythm was chosen as 40%, the sensitivity and specificity of ECoG mapping of motor cortex were 81.08% (30/37) and 83.33% (25/30). The ERD threshold of the SCP was chosen as 1.6, the sensitivity and specificity were 83.78% (31/37) and 80% (24/30) respectively. Combined μ rhythm with SCP mapping revealed high sensitivity (97.29%, 36/37) and moderate specificity (80%, 24/30) as compared with DES when D mode (sensitive priority mode) was chosen, that was either μ rhythm or SCP positive was defined as the motor cortex. Conclusions: The ECoG analysis has a higher sensitivity to locate the motor cortex without stimulating the brain. It is expected as a new adjuvant to DES for intraoperative mapping of eloquent cortex.
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