Article
Functional neuronavigation in lesions of the central region by means of magnetoencephalography: practicability and clinical results
Funktionelle Neuronavigation bei Läsionen im Bereich der Zentralregion mittels Magnetoencephalographie: Praktikabilität und klinische Ergebnisse
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Published: | May 4, 2005 |
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Outline
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Objective
MEG is increasingly being used for the non-invasive functional preoperative mapping and for intraoperative functional neuronavigation in patients with brain tumours in or around the central region. The aim of the present study was to assess the practicability of MEG-supported functional neuronavigation (FN) and to evaluate the clinical outcome in patients with tumours of the central region operated with the aid of MEG-supported FN (group 1) as compared to patients with tumours of the central region operated without the aid of MEG-supported FN (group 2).
Methods
From January 2000 until December 2004, a preoperative MEG was obtained in 73 patients with intracranial lesions in or adjacent to the central region. In 45 out of these 73 patients, a source localisation could be calculated from the MEG signals, whereas in the remaining 28 patients this was not possible, mainly because of heavy artifacts in the MEG signal. MEG was performed using a 148-channel whole-head biomagnetometer (Magnes 2500 WH, Bti, San Diego, USA). The central region was identified by means of magnetic source imaging following the application of tactile stimuli to the right and left index fingers. The surgical outcome was assessed on the 1st and 7th postoperative day.
Results
In the patients of group 1, MEG source localisation could be integrated in all cases in the intraoperative FN. 11 out of the 45 patients of group 1 harbouring a tumour in the central region experienced a postoperative deterioration of a preexistent hemiparesis, which however resolved in all cases with two exceptions up to the 7th postoperative day. In comparison, a transient deterioration was observed in 7 and a lasting deterioration in 3 out the 28 patients of group 2.
Conclusions
In our series, no marked difference in clinical outcome could be observed between patients operated with and without the aid of MEG-supported FN. Therefore, although MEG appears to emerge as a useful and reliable additional tool for preoperative localisation of the central region, the clinical importance of MEG-supported neuronavigation for function-preserving operations of tumours in the central region has still to be established.