The goal of this paper was to overview functional brain mapping for intraoperative motor evoked potentials recorded from muscles (cortico-muscular MEPs) and corticospinal MEPs recorded from the cervical epidural space (corticospinal MEPs) to assess their efficacy in the intraoperative monitoring of motor function. Validation for preoperative mapping and intraoperative evaluation with mapping-based cortico-muscular MEPs were discussed. Patients showed a substantial decrease in the amplitude of the muscle MEP without deterioration in the corticospinal D wave, and exhibited severe immediate postoperative motor dysfunction. This indicates dysfunction of the cortical gray matter, including the motor cortices and/or supplementary motor or other extra-motor cortical areas, which are supposed to configuration of I waves. Multimodal method (DTI, fMRI) combined with TMS-based preoperative mapping of primary motor cortex could helpful for integrated general intraoperative evaluation.
"},{"@language":"ja","@value":"運動誘発電位 (motor evoked potential; MEP) 術中モニタリングには術前・術中マッピングを必ずしも必要としないことがある。特に経頭蓋刺激–末梢神経筋電図記録が広く用いられるようになった昨今においては尚更である。前頭葉・頭頂葉には運動感覚の高次中枢が局在する。手術計画に必要な機能検査のうち電気生理学的検査法は, それ単独で成り立つものではなく, MRIなどの形態的評価とともに行うべきものである。術前・術中マッピングは本特集の各項でその詳細が記載されるMEP同様, Neuronavigation (DTI, fMRI) などとともに時間軸を同じくするモダリティの一つであり, いずれも手術を確実安全に行うための評価法である。運動遂行プログラムの流れの中でもMEPの位置づけ, MEPの神経生理学的意義, マルチモダリティ–術前・術中マッピングについて概説する。
"}],"abstractLicenseFlag":"disallow"}],"creator":[{"@id":"https://cir.nii.ac.jp/crid/1420845751166968064","@type":"Researcher","personIdentifier":[{"@type":"KAKEN_RESEARCHERS","@value":"90231563"},{"@type":"NRID","@value":"1000090231563"},{"@type":"NRID","@value":"9000286627379"},{"@type":"NRID","@value":"9000257960978"},{"@type":"NRID","@value":"9000392140936"},{"@type":"NRID","@value":"9000369342893"},{"@type":"NRID","@value":"9000256474636"},{"@type":"NRID","@value":"9000003593104"},{"@type":"NRID","@value":"9000273024754"},{"@type":"NRID","@value":"9000314066042"},{"@type":"NRID","@value":"9000410319962"},{"@type":"NRID","@value":"9000020723583"},{"@type":"NRID","@value":"9000398126698"},{"@type":"NRID","@value":"9000378113923"},{"@type":"NRID","@value":"9000362823870"},{"@type":"NRID","@value":"9000283549918"},{"@type":"RESEARCHMAP","@value":"https://researchmap.jp/read0072816"}],"foaf:name":[{"@language":"ja","@value":"藤木 稔"},{"@language":"en","@value":"Fujiki Minoru"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Neurosurgery, School of Medicine, Oita University"},{"@language":"ja","@value":"大分大学医学部脳神経外科学"}]}],"publication":{"publicationIdentifier":[{"@type":"PISSN","@value":"13457101"},{"@type":"EISSN","@value":"2188031X"},{"@type":"NDL_BIB_ID","@value":"000000108137"},{"@type":"ISSN","@value":"13457101"},{"@type":"LISSN","@value":"13457101"},{"@type":"NCID","@value":"AA11410258"}],"prism:publicationName":[{"@language":"en","@value":"Japanese Journal of Clinical Neurophysiology"},{"@language":"ja","@value":"臨床神経生理学"},{"@language":"en","@value":"Jpn J Clin Neurophysiol"},{"@language":"ja","@value":"臨床神経生理"}],"dc:publisher":[{"@language":"en","@value":"Japanese Society of Clinical Neurophysiology"},{"@language":"ja","@value":"一般社団法人 日本臨床神経生理学会"}],"prism:publicationDate":"2016","prism:volume":"44","prism:number":"4","prism:startingPage":"181","prism:endingPage":"184"},"url":[{"@id":"http://id.ndl.go.jp/bib/027694170"},{"@id":"https://ndlsearch.ndl.go.jp/books/R000000004-I027694170"}],"availableAt":"2016","dataSourceIdentifier":[{"@type":"JALC","@value":"oai:japanlinkcenter.org:2003052344"},{"@type":"NDL_SEARCH","@value":"oai:ndlsearch.ndl.go.jp:R000000004-I027694170"},{"@type":"CIA","@value":"130005966924"}]}