Artikel
Optical imaging of cerebral activation after functional stimulation – a prospective RGB camera study
Optical Imaging der zerebralen Aktivierung nach funktioneller Stimulation – eine prospektive RGB-Kamera-Studie
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Autoren
Veröffentlicht: | 8. Mai 2019 |
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Gliederung
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Objective: Intraoperative Optical Imaging (IOI) is a markerfree, contactless, and non-invasive technique to monitor changes in cerebral metabolism. We used the technique in the past to visualize functional areas during the surgical procedure. To improve the integration of the technique into the OR we further on demonstrated the feasibility of the imaging method using standard RGB camera equipment but only on a very small patient cohort. Here, we performed a prospective study on a larger patient cohort to verify our results, to improve the statistical significance, and to identify potential problems that might occur during routine use.
Methods: Measurements were performed on 16 patients that underwent resection of cortical lesions. In 14 cases median nerve stimulation was performed according to IOI protocol (9 repetitions, 30 s rest/stimulation trials) and two-dimensional maps were calculated visualizing color-coded areas of neuronal activity following stimulation. The localization of the somatosensory cortex was compared between computed IOI maps and electrophysiological measurement of the phase reversal. In two patients the motor cortex was identified by IOI using a motor task in local anesthesia and the results again were compared to electrophysiological measurements.
Results: In 11 out of the 14 median nerve stimulation cases, IOI was able to identify and visualize clearly the median nerve area of the postcentral region in correspondence to the electrophysiological measurements. In two cases only very low IOI activity was visible within the computed maps, whereas the electrophysiology still was able to deliver plausible results. In one case, the stimulated area was not trepanned and no activity was visible within IOI. The motor cortex stimulations revealed in both cases plausible results using IOI and electrophysiology. The overall sensitivity of IOI using RGB camera equipment in our investigation was 87% (11/13, 85% somatosensory cortex, 2/2, 100% motor cortex).
Conclusion: The study revealed a high sensitivity of IOI with RGB camera equipment for identification of functional areas within the central region. The main advantage is the spatially highly resolved visualization of the functional area compared to only punctual electrophysiological measurements.