皮质脑电图μ节律术中定位运动区皮质的研究

摘要

目的 探索皮质脑电图(ECoG)μ节律分析定位运动区皮质的应用价值.方法 回顾性分析8例大脑功能区病变病例资料,均在全麻术中唤醒状态下手术,术中皮质直接电刺激(DES)定位运动区皮质.采集静息、手运动任务下ECoG信号,提取ECoG 4个主要节律:δ、θ、μ、β,分析每个节律的事件相关去同步化现象(ERD),评价ECoG定位运动区皮质的灵敏性与特异性.结果 术中DES均成功定位病人运动区皮质.在运动状态下,ECoG信号μ节律ERD变化最明显,其是运动区皮质的特征节律.以40％阈值为特征值,μ节律定位有较高灵敏性(81.0％)和特异性(91.7％).结论 ECoG μ节律分析可用于术中定位运动区皮质,有望成为术中定位运动区的一种新方法.%Objective To explore the value of electrocorticography (ECoG) in intraoperative mapping of motor cortices. Methods The clinical data of 8 patients with brain lesions near the eloquent areas were analyzed retrospectively. All patients were treated under awake craniotomy. The motor cortices were detected by intraoperative direct electrical stimulation (DES). The ECoG signals were collected from patients in hand-move state (grasp and extension motion) and resting-state. The ECoG signals were decomposed into 4 types of rhythm (δ, θ, μ, β), the event-related desynchronization (ERD) of each rhythm was analyzed. The sensitivity and specificity of ECoG in mapping of motor cortices were evaluated. Results Motor areas were identified by DES in all patients. The ERD of μ rhythm was significant and regarded as the specific rhythm of the motor cortex. When the threshold of ERD of μ rhythm was chosen as 40％, this method showed the optimal sensitivity (81.0％) and specificity (91.7％). Conclusions Data analyzing of μ rhythm from ECoG can be used to map motor areas intraoperatively. It will be expected to become a new method for intraoperative mapping of the motor cortex.