| Project/Area Number |
17H06815
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| Research Category |
Grant-in-Aid for Research Activity Start-up
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| Allocation Type | Single-year Grants |
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| Research Field |
Neurosurgery
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| Research Institution | Kyoto University |
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Principal Investigator |
Yamao Yukihiro 京都大学, 医学研究科, 特定病院助教 (90736810)
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| Project Period (FY) |
2017-08-25 – 2019-03-31
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| Project Status |
Completed (Fiscal Year 2018)
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| Budget Amount *help |
¥2,730,000 (Direct Cost: ¥2,100,000、Indirect Cost: ¥630,000)
Fiscal Year 2018: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
Fiscal Year 2017: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
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| Keywords | awake surgery / language network / white matter pathway / electrical stimulation / 覚醒下手術 / 言語白質線維路 / トラクトグラフィー / CCEP / 電気刺激 / 言語機能 / 白質繊維 / 術中電気刺激 / 白質線維路 |
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| Outline of Final Research Achievements |
To preserve postoperative language function, the intraoperative method to identify the white matter language pathway was mainly developed. By direct single-pulse electrical stimulation to the cortex, cortico-cortical evoked potentials (CCEPs) were recorded from the remote cortex through cortico-cortical connections in the extraoperative setting, to probe functional networks. The CCEP connectivity was able to map language networks even in the intraoperative setting, mainly in the awake condition.
In order to evaluate the clinical utility of intraoperative CCEP monitoring under general anesthesia, CCEP waveforms were compared between general anesthesia and awake condition. CCEP distribution is not affected by anesthetics, and CCEP N1 amplitude increased from general anesthesia to awake condition. Thus, CCEPs potentially enable monitoring of language function during surgery only under general anesthesia.
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| Academic Significance and Societal Importance of the Research Achievements |
脳機能周囲に存在する病変を摘出する際には、病変の最大限の摘出かつ術後の機能温存が望まれる。現在術中に言語機能モニタリングが可能な電気生理学検査は確立していない。これまでCCEPはおもに覚醒下手術での有用性を確認してきたが、麻酔の影響を受けないことを示したことにより、全身麻酔下でも有用な方法であることが示唆された。この手法を用いた術中へのモニタリング適応が広がることで、今後、言語機能白質線維路の同定および術後の言語機能温存へと広がることが望まれる。
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