Intraoperative Neurophysiological Monitoring During Adult Brainstem Glioma Resection: Association Between Electrophysiological Changes and Early Neurological Outcome.

Λεπτομέρειες βιβλιογραφικής εγγραφής
Τίτλος:	Intraoperative Neurophysiological Monitoring During Adult Brainstem Glioma Resection: Association Between Electrophysiological Changes and Early Neurological Outcome.
Συγγραφείς:	Pauletto G; Neurology Unit, Head-Neck and Neuroscience Department, Santa Maria della Misericordia University Hospital, 33100 Udine, Italy., Skrap B; Neurosurgery Unit, Head-Neck and Neuroscience Department, Santa Maria della Misericordia University Hospital, 33100 Udine, Italy., Tomasino B; Scientific Institute, IRCCS E. Medea, 33037 Pasian di Prato, Italy., Lettieri C; Clinical Neurology Unit, Head-Neck and Neuroscience Department, Santa Maria della Misericordia University Hospital, 33100 Udine, Italy., Ecoretti E; Neurophysiology Unit, Head-Neck and Neuroscience Department, Santa Maria della Misericordia University Hospital, 33100 Udine, Italy., Skrap M; Independent Researcher, 34151 Trieste, Italy., Landi A; Academic Neurosurgery, Department of Neurosurgery, University of Padova, 35128 Padova, Italy., Denaro L; Academic Neurosurgery, Department of Neurosurgery, University of Padova, 35128 Padova, Italy., Vindigni M; Neurosurgery Unit, Head-Neck and Neuroscience Department, Santa Maria della Misericordia University Hospital, 33100 Udine, Italy., Robiony M; Clinical Unit of Maxillofacial Surgery, Head-Neck and Neuroscience Department, Santa Maria della Misericordia University Hospital, 33100 Udine, Italy., Valente M; Clinical Neurology Unit, Head-Neck and Neuroscience Department, Santa Maria della Misericordia University Hospital, 33100 Udine, Italy.; Department of Medicine (DMED), University of Udine, 33100 Udine, Italy., Ius T; Academic Neurosurgery, Department of Neurosurgery, University of Padova, 35128 Padova, Italy., Verriello L; Neurology Unit, Head-Neck and Neuroscience Department, Santa Maria della Misericordia University Hospital, 33100 Udine, Italy.
Πηγή:	Current oncology (Toronto, Ont.) [Curr Oncol] 2026 Aug 15; Vol. 33 (8). Date of Electronic Publication: 2026 Aug 15.
Τύπος έκδοσης:	Journal Article
Γλώσσα:	English
Στοιχεία περιοδικού:	Publisher: MDPI Country of Publication: Switzerland NLM ID: 9502503 Publication Model: Electronic Cited Medium: Internet ISSN: 1718-7729 (Electronic) Linking ISSN: 11980052 NLM ISO Abbreviation: Curr Oncol Subsets: MEDLINE
Imprint Name(s):	Publication: 2021- : Basel, Switzerland : MDPI Original Publication: Toronto : Multimed, c1994-
Ιατρικοί όροι (MeSH):	Glioma/surgery , Glioma/physiopathology , Intraoperative Neurophysiological Monitoring/methods , Brain Stem Neoplasms/surgery , Brain Stem Neoplasms*/physiopathology, Humans ; Female ; Male ; Adult ; Middle Aged ; Retrospective Studies ; Evoked Potentials, Somatosensory ; Evoked Potentials, Motor ; Aged ; Electromyography ; Evoked Potentials, Auditory, Brain Stem
Περίληψη:	Intraoperative neurophysiological monitoring (IONM) is widely used during brainstem surgery to reduce the risk of neurological injury, although its prognostic value in adult brainstem glioma (BSG) surgery remains unclear. We retrospectively analyzed 22 consecutive adults who underwent surgery for BSGs with multimodal IONM between 2010 and 2023. Monitoring included somatosensory evoked potentials (SSEPs), motor evoked potentials (MEPs), brainstem auditory evoked potentials (BAEPs), corticobulbar MEPs (CoMEPs), and cranial nerves electromyography. The primary endpoint was the association between intraoperative neurophysiological changes and postoperative neurological functional status at hospital discharge, assessed with the modified McCormick Scale (mMCS). Secondary endpoints included postoperative complications and length of hospital stay. SSEP warning criteria were met in 10 patients (45.5%), while 10 patients (45.5%) experienced a ≥50% reduction in MEP amplitude in at least one monitored muscle. Despite these findings, neither SSEP nor MEP amplitude changes were significantly associated with postoperative neurological status. Transcranial MEP stimulation thresholds increased significantly during surgery (p = 0.007), and threshold elevation was associated with postoperative complications (Kendall's τ = 0.498, p = 0.007). BAEP recordings remained stable throughout all procedures. Conventional amplitude-based IONM changes were not associated with early neurological outcome after adult BSG resection. In contrast, increases in MEP stimulation threshold may represent a sensitive indicator of postoperative complications. Further prospective studies are warranted.
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Contributed Indexing:	Keywords: MEP stimulation threshold; adult brainstem glioma; brainstem surgery; intraoperative neurophysiological monitoring; neurological outcome
Entry Date(s):	Date Created: 20260826 Date Completed: 20260826 Latest Revision: 20260828
Update Code:	20260828
PubMed Central ID:	PMC13511618
DOI:	10.3390/curroncol33080481
PMID:	42645386
Βάση Δεδομένων:	MEDLINE

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ISSN:	1718-7729
DOI:	10.3390/curroncol33080481