Updates on intraoperative neurophysiological monitoring

doi:10.3969/j.issn.1672-6731.2020.11.001

Abstract

Abstract:

Intraoperative neurophysiological monitoring (IONM) is known to monitor the functional integrity of the nervous system and reflect the existence of nerve injury through the application of various neurophysiological techniques to protect neural structures at risk. IONM also plays an important role in functional areas mapping and identification of specific nerves or structures. Though it becomes a widely used mature technology, there are still many problems need to be further discussed.

Key words: Electrophysiology, Monitoring, intraoperative, Evoked potentials, Electromyography, Electroencephalography, Review

摘要：

术中神经电生理监测通过多种神经电生理技术，监测神经传导的完整性，实时反映术中神经功能，以减少潜在的神经损伤，提高手术疗效。术中神经电生理监测在辅助定位皮质功能区和重要神经传导通路、辨别特定神经组织方面同样发挥重要作用，目前已成为普遍应用的成熟技术，但也存在诸多问题。本文简要概述术中神经电生理监测的现状与进展。

关键词: 电生理学, 监测,手术中, 诱发电位, 肌电描记术, 脑电描记术, 综述

ZHANG Jian-guo, QIAO Hui. Updates on intraoperative neurophysiological monitoring[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2020, 20(11): 929-935.

张建国, 乔慧. 术中神经电生理监测现状与进展[J]. 中国现代神经疾病杂志, 2020, 20(11): 929-935.

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References

[1] Lindsay SL, McCanney GA, Willison AG, Barnett SC. Multi-target approaches to CNS repair:olfactory mucosa-derived cells and heparan sulfates[J]. Nat Rev Neurol, 2020, 16:229-240.
[2] Expert Committee of Neuroelectrophysiological Monitoring, Neurosurgical Branch, Chinese Medical Doctors Association. Chinese specifications for electrophysiological monitoring in neurosurgery (2017 edition)[J]. Zhonghua Yi Xue Za Zhi, 2018, 98:1283-1293.[中国医师协会神经外科分会神经电生理监测专家委员会. 中国神经外科术中电生理监测规范(2017版)[J]. 中华医学杂志, 2018, 98:1283-1293.]
[3] Qiao H, Chang PF. The importance of intraoperative neuroelectrophysiological monitoring[J]. Zhonghua Shen Jing Wai Ke Za Zhi, 2010, 26:1057-1058.[乔慧, 常鹏飞. 开展术中神经电生理监测的重要性[J]. 中华神经外科杂志, 2010, 26:1057-1058.]
[4] Penfield W, Boldrey E. Somatic motor and sensory representation in the cerebral cortex of man as studied by electrical stimulation[J]. Brain, 2006, 60:389-443.
[5] Legatt AD, Emerson RG, Epstein CM, MacDonald DB, Deletis V, Bravo RJ, López JR. ACNS guideline:transcranial electrical stimulation motor evoked potential monitoring[J]. J Clin Neurophysiol, 2016, 33:42-50.
[6] Mooij JJ, Mustafa MK, van Weerden TW. Hemifacial spasm:intraoperative electromyographic monitoring as a guide for microvascular decompression[J]. Neurosurgery, 2001, 49:1365-1370.
[7] Sasaki T, Itakura T, Suzuki K, Kasuya H, Munakata R, Muramatsu H, Ichikawa T, Sato T, Endo Y, Sakuma J, Matsumoto M. Intraoperative monitoring of visual evoked potential:introduction of a clinically useful method[J]. J Neurosurg, 2010, 112:273-284.
[8] Helbok R, Schiefecker AJ, Beer R, Dietmann A, Antunes AP, Sohm F, Fischer M, Hackl WO, Rhomberg P, Lackner P, Pfausler B, Thomé C, Humpel C, Schmutzhard E. Early brain injury after aneurysmal subarachnoid hemorrhage:a multimodal neuromonitoring study[J]. Crit Care, 2015, 19:75.
[9] Brodsky MA, Anderson S, Murchison C, Seier M, Wilhelm J, Vederman A, Burchiel KJ. Clinical outcomes of asleep vs awake deep brain stimulation for Parkinson disease[J]. Neurology, 2017, 89:1944-1950.
[10] Nuwer MR, Dawson EG, Carlson LG, Kanim LE, Sherman JE. Somatosensory evoked potential spinal cord monitoring reduces neurologic deficits after scoliosis surgery:results of a large multicenter survey[J]. Electroencephalogr Clin Neurophysiol, 1995, 96:6-11.
[11] Neuroelectrophysiology Group of Spinal Surgery, Spinal Cord Professional Committee, Chinese Rehabilitation Medical Association. Expert consensus on standardized intraoperative neuroelectrophysiological monitoring during spinal surgery[J]. Zhongguo Ji Zhu Ji Sui Za Zhi, 2019, 29:944-954.[中国康复医学会脊柱脊髓专业委员会脊柱外科神经电生理学组. 规范化脊柱外科术中神经电生理监测技术的专家共识[J]. 中国脊柱脊髓杂志, 2019, 29:944-954.]
[12] Kombos T, Suess O, Funk T, Kern BC, Brock M. Intra-operative mapping of the motor cortex during surgery in and around the motor cortex[J]. Acta Neurochir (Wien), 2000, 142:263-268.
[13] Cedzich C, Taniguchi M, Schäfer S, Schramm J. Somatosensory evoked potential phase reversal and direct motor cortex stimulation during surgery in and around the central region[J]. Neurosurgery, 1996, 38:962-970.
[14] Trenado C, Elben S, Friggemann L, Groiss SJ, Vesper J, Schnitzler A, Wojtecki L. Intraoperative localization of the subthalamic nucleus using long-latency somatosensory evoked potentials[J]. Neuromodulation, 2018, 21:582-587.
[15] Baker A, Widrich J. Somatosensory evoked potentials[DB/OL]. Treasure Island (FL):StatPearls Publishing, 2020[2020-07-01].https://www.ncbi.nlm.nih.gov/books/NBK544358/.
[16] Sloan TB, Heyer EJ. Anesthesia for intraoperative neurophysiologic monitoring of the spinal cord[J]. J Clin Neurophysiol, 2002, 19:430-443.
[17] Neu M, Strauss C, Romstöck J, Bischoff B, Fahlbusch R. The prognostic value of intraoperative BAEP patterns in acoustic neurinoma surgery[J]. Clin Neurophysiol, 1999, 110:1935-1941.
[18] Thirumala PD, Carnovale G, Habeych ME, Crammond DJ, Balzer JR. Diagnostic accuracy of brainstem auditory evoked potentials during microvascular decompression[J]. Neurology, 2014, 83:1747-1752.
[19] Gugel I, Grimm F, Liebsch M, Zipfel J, Teuber C, Kluwe L, Mautner VF, Tatagiba M, Schuhmann MU. Impact of surgery on long-term results of hearing in neurofibromatosis Type-2 associated vestibular schwannomas[J]. Cancers (Basel), 2019, 11:1376.
[20] Macdonald DB, Stigsby B, Al Homoud I, Abalkhail T, Mokeem A. Utility of motor evoked potentials for intraoperative nerve root monitoring[J]. J Clin Neurophysiol, 2012, 29:118-125.
[21] Leppanen RE. Intraoperative monitoring of segmental spinal nerve root function with free-run and electrically-triggered electromyography and spinal cord function with reflexes and F-responses:a position statement by the American Society of Neurophysiological Monitoring[J]. J Clin Monit Comput, 2005, 19:437-461.
[22] Thirumala PD, Natarajan P, Thiagarajan K, Crammond DJ, Habeych ME, Chaer RA, Avgerinos ED, Friedlander R, Balzer JR. Diagnostic accuracy of somatosensory evoked potential and electroencephalography during carotid endarterectomy[J]. Neurol Res, 2016, 38:698-705.
[23] Lozano CS, Ranjan M, Boutet A, Xu DS, Kucharczyk W, Fasano A, Lozano AM. Imaging alone versus microelectrode recording-guided targeting of the STN in patients with Parkinson's disease[J]. J Neurosurg, 2018.[Epub ahead of print]
[24] Shang M, Li ST. Application of electrophysiological monitoring in microvascular decompression of facial spasm[J]. Zhonghua Shen Jing Wai Ke Ji Bing Yan Jiu Za Zhi, 2012, 11:373-375.[尚明, 李世亭. 电生理监测在面肌痉挛微血管减压术中的应用[J]. 中华神经外科疾病研究杂志, 2012, 11:373-375.]
[25] Sindou M, Mercier P. Microvascular decompression for hemifacial spasm:surgical techniques and intraoperative monitoring[J]. Neurochirurgie, 2018, 64:133-143.
[26] von Eckardstein K, Harper C, Castner M, Link M. The significance of intraoperative electromyographic "lateral spread" in predicting outcome of microvascular decompression for hemifacial spasm[J]. J Neurol Surg B Skull Base, 2014, 75:198-203.
[27] Wei Y, Yang W, Zhao W, Pu C, Li N, Cai Y, Shang H. Microvascular decompression for hemifacial spasm:can intraoperative lateral spread response monitoring improve surgical efficacy[J]? J Neurosurg, 2018, 128:885-890.
[28] Lee SH, Park BJ, Shin HS, Park CK, Rhee BA, Lim YJ. Prognostic ability of intraoperative electromyographic monitoring during microvascular decompression for hemifacial spasm to predict lateral spread response outcome[J]. J Neurosurg, 2017, 126:391-396.
[29] Lee S, Park SK, Lee JA, Joo BE, Kong DS, Seo DW, Park K. A new method for monitoring abnormal muscle response in hemifacial spasm:a prospective study[J]. Clin Neurophysiol, 2018, 129:1490-1495.
[30] Zheng X, Hong W, Tang Y, Ying T, Wu Z, Shang M, Feng B, Zhang W, Hua X, Zhong J, Li S. Discovery of a new waveform for intraoperative monitoring of hemifacial spasms[J]. Acta Neurochir (Wien), 2012, 154:799-805.
[31] Li QX, Zhao XJ, Fu AJ, Li XN, Zhang YH, Cheng J, Lü XS, Liu G. Application of multi-mode neuroelectrophysiological monitoring in spinal surgery[J]. Zhongguo Wei Qin Xi Shen Jing Wai Ke Za Zhi, 2019, 24:494-496.[李群喜, 赵晓晶, 付爱军, 李向男, 张云鹤, 成杰, 吕小生, 刘刚. 多模式神经电生理监测在脊柱手术的应用[J]. 中国微侵袭神经外科杂志, 2019, 24:494-496.]
[32] Daniel JW, Botelho RV, Milano JB, Dantas FR, Onishi FJ, Neto ER, Bertolini EF, Borgheresi MAD, Joaquim AF. Intraoperative neurophysiological monitoring in spine surgery:asystematic review and Meta-analysis[J]. Spine (Phila Pa 1976), 2018, 43:1154-1160.
[33] Turner RP. Neurophysiologic intraoperative monitoring during selective dorsal rhizotomy[J]. J Clin Neurophysiol, 2009, 26:82-84.
[34] Salehi S, Nemati H, Soltani A. Intraoperative neurophysiology monitoring during selective dorsal rhizotomy for spastic cerebral palsy[J]. Iranian J Neurosurg, 2018, 4:117-122.
[35] Hill NJ, Gupta D, Brunner P, Gunduz A, Adamo MA, Ritaccio A, Schalk G. Recording human electrocorticographic (ECoG) signals for neuroscientific research and real-time functional cortical mapping[J]. J Vis Exp, 2012, (64):3993.
[36] San-juan D, Tapia CA, González-Aragón MF, Martínez Mayorga A, Staba RJ, Alonso-Vanegas M. The prognostic role of electrocorticography in tailored temporal lobe surgery[J]. Seizure, 2011, 20:564-569.
[37] Roessler K, Heynold E, Buchfelder M, Stefan H, Hamer HM. Current value of intraoperative electrocorticography (iopECoG)[J]. Epilepsy Behav, 2019, 91:20-24.
[38] Park CJ, Hong SB. High frequency oscillations in epilepsy:detection methods and considerations in clinical application[J]. J Epilepsy Res, 2019, 9:1-13.
[39] Parvizi J, Kastner S. Promises and limitations of human intracranial electroencephalography[J]. Nat Neurosci, 2018, 21:474-483.
[40] Anderson WS, Winberry J, Liu CC, Shi C, Lenz FA. Applying microelectrode recordings in neurosurgery[J]. Contemp Neurosurg, 2010, 32:1-7.
[41] El-Tahawy H, Lozano AM, Dostrovsky JO. Elect rophysiological Findings in Vim and Vc[M]. New York:Thieme, 2003:63-70.
[42] Du G, Zhuang P, Hallett M, Zhang YQ, Li JY, Li YJ. Properties of oscillatory neuronal activity in the basal ganglia and thalamus in patients with Parkinson's disease[J]. Transl Neurodegener, 2018, 7:17.
[43] Zaidel A, Spivak A, Grieb B, Bergman H, Israel Z. Subthalamic span of beta oscillations predicts deep brain stimulation efficacy for patients with Parkinson's disease[J]. Brain, 2010, 133(Pt 7):2007-2021.
[44] Reck C, Maarouf M, Wojtecki L, Groiss SJ, Florin E, Sturm V, Fink GR, Schnitzler A, Timmermann L. Clinical outcome of subthalamic stimulation in Parkinson's disease is improved by intraoperative multiple trajectories microelectrode recording[J]. J Neurol Surg A Cent Eur Neurosurg, 2012, 73:377-386.
[45] Wang S. Application of neuroelectrophysiological monitoring in the surgical treatment of cerebrovascular diseases[J]. Zhonghua Yi Xue Za Zhi, 2015, 95:1636-1638.[王硕. 神经电生理监测在脑血管疾病手术治疗中的应用[J]. 中华医学杂志, 2015, 95:1636-1638.]
[46] The 13th Chinese Cerebrovascular Disease Forum (2016/4/9-4/11, Beijing)[J]. Zhonghua Shen Jing Chuang Shang Wai Ke Dian Zi Za Zhi, 2016, 2:186.[第十三届中国脑血管病论坛(2016/4/9-4/11,北京)[J]. 中华神经创伤外科电子杂志, 2016, 2:186.]
[47] GBD 2016 Brain and Other CNS Cancer Collaborators. Global, regional, and national burden of brain and other CNS cancer, 1990-2016:a systematic analysis for the Global Burden of Disease Study 2016[J]. Lancet Neurol, 2019, 18:376-393.
[48] Qiao H, Chang PF. Intraoperative neuroelectrophysiological monitoring-a new perspective of neurosurgery[J]. Zhonghua Shen Jing Wai Ke Za Zhi, 2011, 27:541-542.[乔慧, 常鹏飞. 术中神经电生理监测-神经外科的新视点[J]. 中华神经外科杂志, 2011, 27:541-542.]
[49] Liu XZ. Clinical application of neuroelectrophysiological monitoring[J]. Zhonghua Yi Xue Za Zhi, 2015, 95:1633-1635.[刘献增. 神经电生理监测的临床应用[J]. 中华医学杂志, 2015, 95:1633-1635.]

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