| Project/Area Number |
17591535
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Cerebral neurosurgery
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| Research Institution | Nihon University |
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Principal Investigator |
FUKAYA Chikashi Nihon University, School of Medicine, Associate Professor (50287637)
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| Co-Investigator(Kenkyū-buntansha) |
OSHIMA Hideki Nihon University, School of Medicine, Professor (20328735)
YAMAMOTO Takamitsu Nihon University, School of Medicine, Professor (50158284)
KATAYAMA Yoichi Nihon University, School of Medicine, Professor (00125048)
小林 一太 日本大学, 医学部, 助手 (20366579)
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| Project Period (FY) |
2005 – 2007
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| Project Status |
Completed (Fiscal Year 2007)
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| Budget Amount *help |
¥3,570,000 (Direct Cost: ¥3,300,000、Indirect Cost: ¥270,000)
Fiscal Year 2007: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
Fiscal Year 2006: ¥900,000 (Direct Cost: ¥900,000)
Fiscal Year 2005: ¥1,500,000 (Direct Cost: ¥1,500,000)
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| Keywords | motor evoked potential / D-wave / primary motor cortex / basal ganglia / motor thalamus / intraonerative neuronhysiology / deep brain stimulation / mapping / モニタリング / 皮質脊髄路 / 脳腫瘍 / 運動前野 / 補足運動野 / 運動野 / 電気刺激 / 脳外科手術 / D wave / 運動領野 / 機能野 |
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| Research Abstract |
On tumor resection close to the motor pathway, several types of functional mapping such as preoperative neuroimaging and intraoperative electrophysiological techniques have been extensively used in the past few decades to decrease postoperative morbidity. In particular, evoked-potential recording following a direct electrical stimulation of the cortex has been used as an intraoperative mapping and monitoring method during surgery.
The corticospinal D-wave has been confirmed as an indicator for the mapping of M1(primary motor cortex) and for monitoring CST (corticospinal tract) function during surgery. We already reported the functional outcomes due to SMA (supplementary motor cortex) and PM (premotor cortex) impairment are considerably different from that of the M1 impairment. Motor deficit caused by damage to SMA and/or PM is often expected to be compensated, and patients often fully recover in a few months. Therefore, to differentiate the M1 from other motor-related corticies is important. As previously reported, responses from muscles can be evoked by stimulating not only M1 and CST but also SMA, PM, and probably their descending fibers. This feature is unfavorable for achieving maximum tumor resection with minimum postoperative deficits because The corticospinal D-wave can be recorded only when M1 is stimulated.
On the other hand, attention has mainly been paid functional mapping of the cortex. However, intramedullary tumors such as glial tumors commonly invade subcortical structures as well as the cortices ; thus, definitive deficits may occur because of surgical impairments to eloquent pathways running through subcortical structures. Subcortical mapping using the D-wave elicited by monopolar stimulation can provide useful information that can be used to prevent postoperative motor deficit. In particular, the potential of this method for determining the distance of the stimulation point from the CST using D-wave amplitude is promising.
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