中国现代神经疾病杂志 ›› 2020, Vol. 20 ›› Issue (11): 944-948. doi: 10.3969/j.issn.1672-6731.2020.11.003

• 专题讲座 • 上一篇    下一篇

2 语言功能区定位技术及其在神经外科中的应用

徐秦岚1, 强峻1, 刘献增1,2   

  1. 1 102206 北京大学国际医院神经内科;
    2 100191 北京大学临床研究所
  • 收稿日期:2020-11-07 出版日期:2020-11-25 发布日期:2020-12-02
  • 通讯作者: 刘献增,Email:liuxianzeng@pkuih.edu.com

Language function areas mapping and its application in neurosurgery

XU Qin-lan1, QIANG Jun1, LIU Xian-zeng1,2   

  1. 1 Department of Neurology, Peking University International Hospital, Beijing 102206, China;
    2 Peking University Clinical Research Institute, Beijing 100191, China
  • Received:2020-11-07 Online:2020-11-25 Published:2020-12-02

摘要:

神经外科手术的最终目的是在尽可能保留神经功能的前提下最大限度安全切除病灶,运动功能、感觉功能尤其是语言功能的保留意义重大,因此术前和术中功能区定位对手术具有重要指导意义。目前,侵袭性定位方法即术中直接电刺激仍是语言功能区定位和优势侧定位的“金标准”,fMRI、DTI、脑磁图和导航经颅磁刺激等非侵袭性定位方法操作简便,可用于术前定位、术后随访和复查,多模态功能评估可提高术前语言功能区定位的准确性。本文拟对语言功能区的定位方法进行概述,并比较各种方法的优缺点。

关键词: 语言, 大脑皮质, 电刺激, 磁共振成像, 脑磁图描记术, 神经导航, 经颅磁刺激, 综述

Abstract:

The ultimate goal of neurosurgery is to remove the lesion to the greatest extent while retaining neurological function. The preservation of motor function, sensory function, especially language function is of great significance to patients. So preoperative and intraoperative functional mapping has important guidance for surgery. The current invasive method-intraoperative direct electrical stimulation (DES) is still the "gold standard" for language mapping and lateralization, while non-invasive method such as functional magnetic resonance (fMRI), diffusion tensor imaging (DTI), magnetoencephalography (MEG) and navigated transcranial magnetic stimulation (nTMS) are easy to operate and can be used for preoperative positioning, postoperative follow-up and review. Multimodal functional assessment can improve the accuracy of preoperative language mapping. This article intends to review the positioning methods of language function areas and compare the advantages and disadvantages of various methods.

Key words: Language, Cerebral cortex, Electric stimulation, Magnetic resonance imaging, Magnetoencephalography, Neuronavigation, Transcranial magnetic stimulation, Review