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Voluntary Movements

開催日 2014/9/13
時間 17:10 - 18:10
会場 Room H(304)
Chairperson(s) 小池 康晴 / Yasuharu Koike (東京工業大学 / Tokyo Institute of Technology, Japan)
筒井 健一郎 / Ken-ichiro Tsutsui (東北大学大学院生命科学研究科 脳情報処理分野 / Division of Systems Neuroscience, Graduate School of Life Sciences, Tohoku University, Japan)

Motor function after surgery: correlation between outcome and motor network connectivity

  • O3-H-5-2
  • 山尾 幸広 / Yukihiro Yamao:1 澤本 伸克 / Nobukatsu Sawamoto:2 國枝 武治 / Takeharu Kunieda:1 菊池 隆幸 / Takayuki Kikuchi:1 松本 理器 / Riki Matsumoto:2 池田 昭夫 / Akio Ikeda :3 高橋 良輔 / Ryosuke Takahashi:3 福山 秀直 / Hidenao Fukuyama:4 宮本 享 / Susumu Miyamoto:1 
  • 1:京都大学医学部附属病院脳神経外科 / Dept Neurosurg, Kyoto Univ, Kyoto, Japan 2:京都大学医学部附属病院神経内科 / Dept Neurology, Kyoto Univ, Kyoto, Japan 3:京都大学大学院医学研究科てんかん・運動異常生理学講座 / Dept Epilepsy, Movement Disorders and Physiology, Kyoto Univ, Kyoto, Japan 4:京都大学大学院医学研究科脳機能研究センター / HBRC, Kyoto Univ, Kyoto, Japan 

Introduction:In brain tumor surgery near motor cortex, preservation of motor function remains a challenge. Even if intraoperative monitoring of motor evoked potentials (MEPs) was preserved, deterioration of motor performance can be observed. The aim of the present study is to investigate alternations in motor network connectivity associated with postsurgical deterioration in motor performance.
Methods:Twelve patients with brain tumor near motor cortex were participated. According to changes in motor performance after surgery, they were classified into two groups (Fugl-Meyer assessment, group P: motor deficits, group N: no deficits). BOLD fMRI, T1 weighted image, and diffusion weighted image (DWI) were acquired on a 3T MRI before and after surgery. In task related fMRI, subjects underwent (1): index to thumb opposition of right hand, (2): left hand, (3): flexion/extension of right ankle and (4): left ankle. Resting state fMRI (rsfMRI) was also obtained. Task related fMRI were preprocessed and statistically analyzed at single subject level (p<0.05). Using FreeSurfer, hand and foot areas in BA4, medial and lateral BA6 were then specified. DWI data were preprocessed, and probabilistic tractography was run from each voxel in cerebral peduncle to reach hand or foot area of BA4, medial and lateral BA6. For rsfMRI, preprocessed fMRI data were used to generate major Eigen time series representing activity in BA4. Then, the partial correlation scores were calculated for each voxel at group level (p<0.05).
Results:Six patients were classified as group P, and the other six as group N. MEPs did not change in any case. Anatomical connectivity measured with tractography did not show significant difference between two groups. In contrast, functional connectivity of BA4 examined with rsfMRI demonstrated significant intrinsic motor network connectivity breakdown after surgery specifically in group P.
Conclusion:We propose that intact intrinsic functional motor network connectivity is required to elicit motor output through the corticospinal neurons in BA4.

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