The minimal sub-cortical electronic threshold predicts the motor deficit and survivals in non-awake

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  目的 Direct subcortical electronic stimulation is the golden criteria to identify the motor pathway during glioma surgery.The threshold identified by direct electronic sub-cortical stimulus means the minimal distance away from the motor pathway,and is critical to decide to continue or abort glioma resection.However,the minimal threshold to abort resection in non-awake surgery for gliomas has not been reported.In this study,we identified the cutoff minimal threshold for aborting resection and analyzed its predictive merit on postoperative motor deficit and long-term survivals.方法 We designed this prospective study with high-frequency stimulus method.The cutoff minimal threshold to predict motor deficits was identified with receiver operator characteristic(ROC)curve and its merit to predict motor deficit and survivals was analyzed.结果 The cutoff minimal monopolar sub-cortical threshold(MSCMT)to predict motor deficit was 3.9mA on day 1,3.7mA on day 7,5.2mA 3 months,and 5.2mA 6 months after surgery.MSCMT ≤3.9mA independently predicted post-operative motor deficits and had no effect on the removal degree of tumor(P>0.05).In high-grade gliomas,MSCMT ≤3.9mA independently predicted shorter progression-free(OR=3.381[1.416-8.076],P=0.006)and overall survivals(OR=3.651[1.336-9.977],P=0.012).结论 This study identified the cutoff MSCMT to avoid postoperative motor deficit.MSCMT independently predicts postoperative motor deficit and prognoses.
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