运动诱发电位监测在预测岛状胶质瘤患者术后运动缺陷中的应用。

IF 2.3 4区 医学 Q3 CLINICAL NEUROLOGY
Journal of Clinical Neurophysiology Pub Date : 2024-09-01 Epub Date: 2023-10-05 DOI:10.1097/WNP.0000000000001026
Xing Fan, Hao You, Jiajia Liu, Xiaorong Tao, Mingran Wang, Ke Li, Jun Yang, Jian Xie, Hui Qiao
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引用次数: 0

摘要

目的:运动诱发电位(MEP)监测已广泛应用于各种神经外科手术中。本研究旨在评估MEP监测对岛叶胶质瘤患者术后运动功能障碍(PMD)的预测价值。方法:回顾性分析42例岛叶神经胶质瘤患者的人口学和临床数据、MEP监测数据和随访数据,最终纳入40例患者。MEP监测预测PMD的价值通过敏感性、特异性和假阳性/假阴性率进行评估。进行二元多元逻辑回归分析,以进一步确定MEP监测的预测价值。结果:统计分析表明,不可逆的MEP变化(但不是所有的MEP变化)在预测PMD方面更有效。不可逆MEP变化预测长期PMD的敏感性和特异性分别为85.71%和93.94%,而假阳性率和阴性率分别为25.00和3.12%。此外,不可逆的MEP变化被确定为长期PMD的唯一独立预测因素(比值比,101.714;95%置信区间,6.001-1724.122;p=0.001)。结论:MEP监测已被证明在岛叶神经胶质瘤手术中是可行的。不可逆的MEP变化在预测PMD方面表现出良好的性能。他们的缺席可以为长期运动结果提供乐观的预期。这些发现可以为外科团队提供对MEP变化的更有效解释,并有助于探索量身定制的MEP警告标准。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Utility of Motor Evoked Potential Monitoring for Predicting Postoperative Motor Deficit in Patients With Insular Gliomas.

Purpose: Motor evoked potential (MEP) monitoring has been widely applied in various neurosurgical operations. This study aimed to assess the predictive value of MEP monitoring for postoperative motor deficit (PMD) in patients with insular gliomas.

Methods: Demographic and clinical data, MEP monitoring data, and follow-up data of 42 insular glioma patients were retrospectively reviewed, and 40 patients were finally enrolled. The value of MEP monitoring for predicting PMD was assessed with sensitivity, specificity, and false-positive/false-negative rates. Binary multivariate logistic regression analysis was performed to further identify the predictive value of MEP monitoring.

Results: Statistical analysis showed that irreversible MEP changes, but not all MEP changes, were more effective in predicting PMD. The sensitivity and specificity of irreversible MEP changes for predicting long-term PMD were 85.71 and 93.94%, whereas the false-positive and -negative rates were 25.00 and 3.12% respectively. In addition, irreversible MEP changes were identified as the only independent predictor for long-term PMD (odds ratio, 101.714; 95% confidence interval, 6.001-1724.122; p = 0.001).

Conclusions: MEP monitoring has been proven to be feasible in insular glioma surgery. Irreversible MEP changes showed good performance in predicting PMD. Their absence can offer an optimistic expectation for the long-term motor outcome. The findings can provide the surgical team with a more effective interpretation of MEP changes and contribute to exploring tailored MEP warning criteria.

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来源期刊
Journal of Clinical Neurophysiology
Journal of Clinical Neurophysiology 医学-临床神经学
CiteScore
4.60
自引率
4.20%
发文量
198
审稿时长
6-12 weeks
期刊介绍: ​The Journal of Clinical Neurophysiology features both topical reviews and original research in both central and peripheral neurophysiology, as related to patient evaluation and treatment. Official Journal of the American Clinical Neurophysiology Society.
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