NITTA Masayuki
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Assistant Professor
Article types Original article
Language English
Peer review Peer reviewed
Presence of invitation Invited paper
Title Localization and symptoms associated with removal of negative motor area during awake surgery.
Journal Formal name:British journal of neurosurgery
Abbreviation:Br J Neurosurg
ISSN code:1360046X/02688697
Domestic / ForeginForegin
Volume, Issue, Page pp.1-9-**
Author and coauthor TSUZUKI Shunsuke†, MURAGAKI Yoshihiro, MARUYAMA Takashi, SAITO Taiichi, NITTA Masayuki, TAMURA Manabu, KAWAMATA Takakazu
Publication date 2023/10/19
Summary BACKGROUND:In awake surgery, cortical mapping may identify the negative motor area (NMA). However, since speech arrest occurs regardless of whether the NMA or the frontal language area (FLA) is stimulated, the presence of speech arrest alone does not distinguish the NMA from the FLA. Furthermore, the exact location and function of the NMA is not well understood. The purpose of this study was to more accurately locate the NMA in a group of cases in which the NMA and FLA could be identified in different brain gyri, and to describe symptoms in cases in which the NMA was removed.METHODS:There were 18 cases of awake surgery at our institution between 2000 and 2013 in which cortical stimulation allowed identification of FLA and NMA in separate brain gyri. In these cases, the pre- and post-removal mapping results were projected onto a 3D model postoperatively. We investigated the symptoms and social rehabilitation in a case in which the tumour invaded the same brain gyrus as the NMA and the NMA had to be resected in combination with the tumour.RESULTS:In cases where the NMA and FLA could be identified in different brain gyri, NMA was localized inferior to the precentral gyrus in all cases. In four cases where NMA was removed with the tumour, apraxia of speech was observed during the surgery; the same symptoms persisted after it, but it improved within a few months, and the patients were able to return to work.CONCLUSION:In cases where NMA and FLA could be identified separately by awake mapping, the NMA was commonly localized inferior to the precentral gyrus. When NMAs were resected in combination with tumour invasion, they did not lead to serious, long-term complications.
DOI 10.1080/02688697.2023.2271082
PMID 37855108