{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,12]],"date-time":"2026-11-12T02:09:52Z","timestamp":1794449392632,"version":"4.9.1"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["NEUROSURGERY","NEUROS"],"published-print":{"date-parts":[[2017,10]]},"abstract":"Abstract<\/jats:title>\n \n BACKGROUND<\/jats:title>\n Intraoperative identification and preservation of the corticospinal tract is often necessary for glioma resection.<\/jats:p>\n <\/jats:sec>\n \n OBJECTIVE<\/jats:title>\n To make a proposal for intraoperative management with the high-frequency monopolar stimulation technique for monitoring the corticospinal tract.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n Ninety-two patients operated on with the assistance of the high-frequency monopolar stimulation. Clinical and neurophysiological data have been related with the motor status at 3 months to establish prognostic factors of motor deterioration.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n Twenty-one patients (22.8%) presented intraoperative alterations in motor-evoked potentials (MEPs). Twelve (13%) presented an increment in the MEP threshold \u22655 mA (no deficit at 3 months). Two (2.2%) presented an MEP amplitude reduction >50% (100% deficit at 3 months). Seven (7.6%) had an intraoperative MEP loss (80% deficit at 3 months). Subcortical stimulation was positive in 75 patients (81.5%). Eighty-five patients were available for the analysis at 3 months. Fourteen presented new deficits (16.5%). Among them, 5 presented a deficit in nonmonitored muscles (5.9%) and 1 presented a new deficit not detected intraoperatively. The combination of patients with preoperative motor deficits, MEP deterioration, or loss and intensity of subcortical stimulation \u22643 mA showed the highest sensitivity and specificity in the prediction of new deficits.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n Persistent MEP loss or deterioration is associated with a high probability of new deficits. It seems recommendable to stop the subcortical resection before obtaining a subcortical MEP threshold at 3 mA especially in patients with preoperative motor deficits. A careful selection of muscles for the registration of MEPs is mandatory to avoid deficits in nonmonitored muscles.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/neuros\/nyw087","type":"journal-article","created":{"date-parts":[[2017,8,16]],"date-time":"2017-08-16T15:59:49Z","timestamp":1502899189000},"page":"585-594","source":"Crossref","is-referenced-by-count":43,"title":["Evaluation of the High-Frequency Monopolar Stimulation Technique for Mapping and Monitoring the Corticospinal Tract in Patients With Supratentorial Gliomas. A Proposal for Intraoperative Management Based on Neurophysiological Data Analysis in a Series of 92 Patients"],"prefix":"10.1227","volume":"81","author":[{"given":"Gerard","family":"Plans","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"Fern\u00e1ndez-Conejero","sequence":"additional","affiliation":[{"name":"Department of Neurophysiology, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xavier","family":"Rif\u00e0-Ros","sequence":"additional","affiliation":[{"name":"Cognition and Brain Plasticity Group, Bellvitge Biomedical Research Institute\u2014IDIBELL, and De-partment of Basic Psychology, Campus Bellvitge, Universitat de Barcelona, L\u2019Hos-pitalet de Llobregat, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Fern\u00e1ndez-Coello","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleix","family":"Rossell\u00f3","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreu","family":"Gabarr\u00f3s","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, 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