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A New Measure for Monitoring Intraoperative Somatosensory Evoked Potentials

  • Jin, Seung-Hyun (Department of Neurosurgery, Seoul National University Hospital) ;
  • Chung, Chun Kee (Department of Neurosurgery, Seoul National University Hospital) ;
  • Kim, Jeong Eun (Department of Neurosurgery, Seoul National University Hospital) ;
  • Choi, Young Doo (Department of Neurosurgery, Seoul National University Hospital)
  • 투고 : 2014.07.08
  • 심사 : 2014.09.15
  • 발행 : 2014.12.28

초록

Objective : To propose a new measure for effective monitoring of intraoperative somatosensory evoked potentials (SEP) and to validate the feasibility of this measure for evoked potentials (EP) and single trials with a retrospective data analysis study. Methods : The proposed new measure (hereafter, a slope-measure) was defined as the relative slope of the amplitude and latency at each EP peak compared to the baseline value, which is sensitive to the change in the amplitude and latency simultaneously. We used the slope-measure for EP and single trials and compared the significant change detection time with that of the conventional peak-to-peak method. When applied to single trials, each single trial signal was processed with optimal filters before using the slope-measure. In this retrospective data analysis, 7 patients who underwent cerebral aneurysm clipping surgery for unruptured aneurysm middle cerebral artery (MCA) bifurcation were included. Results : We found that this simple slope-measure has a detection time that is as early or earlier than that of the conventional method; furthermore, using the slope-measure in optimally filtered single trials provides warning signs earlier than that of the conventional method during MCA clipping surgery. Conclusion : Our results have confirmed the feasibility of the slope-measure for intraoperative SEP monitoring. This is a novel study that provides a useful measure for either EP or single trials in intraoperative SEP monitoring.

키워드

참고문헌

  1. Bai O, Nakamura M, Nagamine T, Shibasaki H : Parametric modeling of somatosensory evoked potentials using discrete cosine transform. IEEE Trans Biomed Eng 48 : 1347-1351, 2001 https://doi.org/10.1109/10.959331
  2. Choi KY, Kim GK, Lim YJ, Kim TS, Leem W, Rhee BA : Comparison of intraoperative somatosensory evoked potential (SSEP) monitoring during aneurysm surgery. J Korean Neurosurg Soc 30 (Suppl 2) : S281-S288, 2001
  3. Freye E : Cerebral monitoring in the operating room and the intensive care unit-an introductory for the clinician and a guide for the novice wanting to open a window to the brain. Part II : Sensory-evoked potentials (SS- EP, AEP, VEP). J Clin Monit Comput 19 : 77-168, 2005 https://doi.org/10.1007/s10877-005-0713-y
  4. Fridman J, John ER, Bergelson M, Kaiser JB, Baird HW : Application of digital filtering and automatic peak detection to brain stem auditory evok-ed potential. Electroencephalogr Clin Neurophysiol 53 : 405-416, 1982 https://doi.org/10.1016/0013-4694(82)90005-0
  5. Friedman WA, Chadwick GM, Verhoeven FJ, Mahla M, Day AL : Monitoring of somatosensory evoked potentials during surgery for middle cerebral artery aneurysms. Neurosurgery 29 : 83-88, 1991 https://doi.org/10.1227/00006123-199107000-00014
  6. Goryawala M, Yaylali I, Cabrerizo M, Vedala K, Adjouadi M : An effective intra-operative neurophysiological monitoring scheme for aneurysm clipping and spinal fusion surgeries. J Neural Eng 9 : 026021, 2012 https://doi.org/10.1088/1741-2560/9/2/026021
  7. Hu Y, Liu H, Luk KD : Time-frequency analysis of somatosensory evoked potentials for intraoperative spinal cord monitoring. J Clin Neurophysiol 28 : 504-511, 2011
  8. Husain AM : A Practical Approach to Neurophysiologic Intraoperative Monitoring. New York : Demos, 2008
  9. Kang D, Yao P, Wu Z, Yu L : Ischemia changes and tolerance ratio of evoked potential monitoring in intracranial aneurysm surgery. Clin Neurol Neurosurg 115 : 552-556, 2013 https://doi.org/10.1016/j.clineuro.2012.06.029
  10. Krayenbühl N, Sarnthein J, Oinas M, Erdem E, Krisht AF : MRI-validation of SEP monitoring for ischemic events during microsurgical clipping of intracranial aneurysms. Clin Neurophysiol 122 : 1878-1882, 2011 https://doi.org/10.1016/j.clinph.2011.02.007
  11. Mizoi K, Yoshimoto T : Permissible temporary occlusion time in aneurysm surgery as evaluated by evoked potential monitoring. Neurosurgery 33 : 434-440; discussion 440, 1993 https://doi.org/10.1227/00006123-199309000-00013
  12. Moller AR : Intraoperative neurophysiological monitoring, ed 3. New York : Springer, 2011
  13. Momma F, Wang AD, Symon L : Effects of temporary arterial occlusion on somatosensory evoked responses in aneurysm surgery. Surg Neurol 27 : 343-352, 1987 https://doi.org/10.1016/0090-3019(87)90009-7
  14. Nave G, Eldar YC, Inbar G, Sinai A, Pratt H, Zaaroor M : Real-time change detection of steady-state evoked potentials. Biol Cybern 107 : 49-59, 2013 https://doi.org/10.1007/s00422-012-0523-5
  15. Nuwer MR : Overview and history in Nuwer MR (ed) : Intraoperative Monitoring of Neural Function. Amsterdam : Elsevier, 2008
  16. Nuwer MR, Packwood JW : Somatosensory evoked potential monitoring with scalp and cervical recording in Nuwer MR (ed) : Intraoperative Monitoring of Neural Function. Amsterdam : Elsevier, 2008
  17. Penchet G, Arné P, Cuny E, Monteil P, Loiseau H, Castel JP : Use of intraoperative monitoring of somatosensory evoked potentials to prevent ischaemic stroke after surgical exclusion of middle cerebral artery aneurysms. Acta Neurochir (Wien) 149 : 357-364, 2007 https://doi.org/10.1007/s00701-007-1119-z
  18. Schick U, Dohnert J, Meyer JJ, Vitzthum HE : Effects of temporary clips on somatosensory evoked potentials in aneurysm surgery. Neurocrit Care 2 : 141-149, 2005 https://doi.org/10.1385/NCC:2:2:141
  19. Schramm J, Koht A, Schmidt G, Pechstein U, Taniguchi M, Fahlbusch R : Surgical and electrophysiological observations during clipping of 134 aneurysms with evoked potential monitoring. Neurosurgery 26 : 61-70, 1990 https://doi.org/10.1227/00006123-199001000-00009
  20. Smith SW : The scientist and engineer's guide to digital signal processing, ed 2. San Diego : California Technical Publishing, 1999
  21. Symon L, Momma F, Murota T : Assessment of reversible cerebral ischaemia in man : intraoperative monitoring of the somatosensory evoked response. Acta Neurochir Suppl (Wien) 42 : 3-7, 1988
  22. Truccolo W, Knuth KH, Shah A, Bressler SL, Schroeder CE, Ding M : Estimation of single-trial multicomponent ERPs : differentially variable component analysis (dVCA). Biol Cybern 89 : 426-438, 2003 https://doi.org/10.1007/s00422-003-0433-7
  23. Wicks RT, Pradilla G, Raza SM, Hadelsberg U, Coon AL, Huang J, et al. : Impact of changes in intraoperative somatosensory evoked potentials on stroke rates after clipping of intracranial aneurysms. Neurosurgery 70 : 1114-1124; discussion 1124, 2012 https://doi.org/10.1227/NEU.0b013e31823f5cf7

피인용 문헌

  1. The Effects of Filter’s Class, Cutoff Frequencies, and Independent Component Analysis on the Amplitude of Somatosensory Evoked Potentials Recorded from Healthy Volunteers vol.19, pp.11, 2014, https://doi.org/10.3390/s19112610