皮质脑电图&mu;节律及慢皮质电位术中定位运动区皮质的方法研究

doi:10.3969/j.issn.1672-6731.2020.11.005

中国现代神经疾病杂志 ›› 2020, Vol. 20 ›› Issue (11): 955-961. doi: 10.3969/j.issn.1672-6731.2020.11.005

2 皮质脑电图μ节律及慢皮质电位术中定位运动区皮质的方法研究

周思捷¹, 唐庆龙², 姜涛³, 杨瑞鑫¹, 战俣飞¹, 刘永超⁴, 朱小艳¹, 白红民¹

1 510010 广州, 解放军南部战区总医院神经外科;
2 100120 北京, 解放军总医院京中医疗区综合内科;
3 510006 广州, 华南理工大学材料科学与工程学院生物医学工程系, 研究生院2015级

收稿日期:2020-11-19 出版日期:2020-11-25 发布日期:2020-12-02
通讯作者: 白红民,Email:baihmfmmu@163.com
基金资助:
广东省科技计划项目（项目编号：2017B020210008）；广东省科技计划项目（项目编号：2014A020215005）

Analysis of μ rhythm and slow cortical potential of electrocorticography for intraoperative mapping of motor cortex

ZHOU Si-jie¹, TANG Qing-long², JIANG Tao³, YANG Rui-xin¹, ZHAN Yu-fei¹, LIU Yong-chao⁴, ZHU Xiao-yan¹, BAI Hong-min¹

1 Department of Neurosurgery, General Hospital of Southern Theatre Command of Chinese PLA, Guangzhou 510010, Guangdong, China;
2 Department of Comprehensive Internal Medicine, Central Medical District of Chinese PLA General Hospital, Beijing 100120, China;
3 Biomedical Engineering, 4 Grade 2015, School of Materials Science and Engineering, South China University of Technology, Guangzhou 510006, Guangdong, China

Received:2020-11-19 Online:2020-11-25 Published:2020-12-02
Supported by:
This study was supported by Science and Technology Planning Project of Guangdong Province (No. 2017B020210008, 2014A020215005).

摘要/Abstract

摘要：

目的探讨采用皮质脑电图术中定位运动区皮质的可行性及临床意义。方法选择2017年6月至2019年6月进行唤醒手术且病变位于运动区的患者共8例，于全身麻醉术中唤醒状态下手术，术中采用皮质直接电刺激定位运动区皮质（金标准），采集静息态和握拳任务下皮质脑电图μ节律和慢皮质电位信号，小波分析上述不同节律运动前后的事件相关去同步化（ERD）特征量的变化，对比μ节律和慢皮质电位单独或联合应用时各阈值及不同模式识别运动区的能力，计算其定位灵敏度、特异度及受试者工作特征曲线下面积。结果（1）当μ节律ERD特征量阈值为40%、慢皮质电位ERD为1.6时，二者定位运动区皮质的灵敏度分别为81.08%（30/37）和83.78%（31/37）、特异度83.33%（25/30）和80%（24/30）。（2）μ节律联合慢皮质电位定位运动区皮质采用D模式（敏感性优先模式即μ节律或慢皮质电位呈阳性反应的区域定义为运动区皮质）时，其定位准确度最高，灵敏度和特异度分别为97.29%（36/37）和80%（24/30）。结论运动前后皮质脑电图分析对定位运动区皮质具有较高的准确性，且对脑组织无不良刺激性，有望成为术中辅助直接电刺激定位的新方法。

关键词: 脑皮层电图, 电刺激, 运动皮质, 脑图

Abstract:

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.

Key words: Electrocorticography, Electric stimulation, Motor cortex, Brain mapping

周思捷, 唐庆龙, 姜涛, 杨瑞鑫, 战俣飞, 刘永超, 朱小艳, 白红民. 皮质脑电图μ节律及慢皮质电位术中定位运动区皮质的方法研究[J]. 中国现代神经疾病杂志, 2020, 20(11): 955-961.

ZHOU Si-jie, TANG Qing-long, JIANG Tao, YANG Rui-xin, ZHAN Yu-fei, LIU Yong-chao, ZHU Xiao-yan, BAI Hong-min. Analysis of μ rhythm and slow cortical potential of electrocorticography for intraoperative mapping of motor cortex[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2020, 20(11): 955-961.

http://journal11.magtechjournal.com/cjcnn/CN/Y2020/V20/I11/955

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2 皮质脑电图μ节律及慢皮质电位术中定位运动区皮质的方法研究

Analysis of μ rhythm and slow cortical potential of electrocorticography for intraoperative mapping of motor cortex

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2 皮质脑电图μ节律及慢皮质电位术中定位运动区皮质的方法研究

Analysis of μ rhythm and slow cortical potential of electrocorticography for intraoperative mapping of motor cortex

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