颅内电极高频脑电定位语言区在癫痫外科的应用  

Application of high gamma ECoG in preoperative assessment of epilepsy surgery

作　　者：周文静[1] 贺晶[1] 张光明[1] 林久銮[1] 洪波[2] 张丹[2] 金真[3] 

机构地区：[1]清华大学玉泉医院癫痫中心, 北京100049 [2]清华大学生物医学工程系 [3]解放军第306医院磁共振室

出　　处：《中华神经外科杂志》2014年第1期28-32,共5页Chinese Journal of Neurosurgery

基　　金：国家重点基础研究发展计划（973计划）（2012CB720704）

摘　　要：目的分析颅内电极高频脑电技术定位语言区，在癫痫外科的应用价值。方法4例优势半球在左侧的难治性癫痫患者，影像检查为阴性，经无创伤检查术前评估预计致痫灶位于左额外侧，接受左额颞开颅电极植入术，确定致痫灶范围后，在患者完成相应语言任务同时，采集信号，分析高频脑电的频谱变化，定位相应语言功能区，并与功能性磁共振（fMRI）、皮层电刺激的结果相比较，设计优化的手术切除计划。结果结合个体化的语言功能定位，4例患者在切除了左额外侧的致痫灶后均无语言功能的缺失。结论颅内电极高频脑电技术是一种省时、精确度较高的功能区定位技术，可以和功能磁共振、皮层电刺激术一起被用于脑功能区的定位，具有很好的发展前景。Objective To explore clinical value of application of high gamma electrolorticograpny （ high gamma ECoG） in preoperative localization of language area for patients with epilepsy. Methods 4 patients with epilepsy of left - predominant hemisphere who were negative in MRI scanning received stereotaetic intracranial electrode implantation of left frontal and temporal lobes. Epileptogenic zone was located in the outside of left frontal lobes after preoperative assessment of epilepsy. At the same time patients carried out the language task and collected signal. Cortical language functional areas were analyzed according to the activation value of high gamma ECoG technology. The results were compared with fMRI^ECS and were planed to decide the surgical location. Results Four patients successfully performed preoperative localization of language and there were no impaired language function after surgery . Conclusions High gamma ECoG technology may be a powerful tool of time - saving and high accuracy, and has good prospects for developmentworking with fMRI、ECS to analyze language functional areas.

关 键 词：癫痫外科 高频皮层脑电技术 语言功能区 皮层电刺激术 功能磁共振 

分 类 号：R742.1[医药卫生—神经病学与精神病学]