neurosurgeryНейрохирургияRussian journal of neurosurgery1683-32952587-7569Издательский дом "МедИНК"10.63769/1683-3295-2017-0-2-55-59neurosurgery-403Research ArticleВ ПОМОЩЬ ПРАКТИЧЕСКОМУ ВРАЧУFOR PRACTITIONERSПланирование радиохирургической операции на аппарате Leksell Gamma Knife Perfexion с использованием различных методов визуализации моторной коры головного мозгаIntegration of different motor cortex mapping methods into Leksell Gamma Knife Perfexion for stereotactic radiosurgery treatment planningТокаревАлексей СергеевичTokarevA. S.mail@rssklif.ruРакВячеслав АвгустовичRakV. A.noemail@neicon.ruСтепановВалентин НиколаевичStepanovV. N.noemail@neicon.ruСинкинМихаил ВладимировичSinkinM. V.mail@rssklif.ruГБУЗ «НИИ скорой помощи им. Н.В. Склифосовского ДЗМ г. Москвы»Russian FederationНИИ скорой помощи им. Н.В. Склифосовского Департамента здравоохранения г. МосквыRussian Federation201724112017025559Copyright © Токарев А.С., Рак В.А., Степанов В.Н., Синкин М.В., 20172017Токарев А.С., Рак В.А., Степанов В.Н., Синкин М.В.Tokarev A.S., Rak V.A., Stepanov V.N., Sinkin M.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.therjn.com/jour/article/view/403

Приведено описание первого опыта использования неинвазивных методов картирования двигательной коры головного мозга при планировании радиохирургической операции на аппарате Leksell Gamma Knife Perfexion у больных со злокачественными новообразованиями головного мозга. Для уменьшения дозовой нагрузки на функционально значимые зоны при планировании облучения использованы методы функциональной МРТ и навигационной транскраниальной магнитной стимуляции. Полученные данные в условиях измененной анатомии головного мозга позволили задать определенную форму пучка с целью снижения риска возникновения двигательных нарушений в послеоперационном периоде.

The first clinical experience of non-invasive motor cortex brain mapping in patients who underwent stereotactic gamma knife radiosurgery for malignant brain tumors is presented. MRI Functional brain mapping (fMRI) and navigated transcranial magnetic stimulation (TMS) were performed to achieve lower doses of eloquent cortex irradiation. Motor mapping allowed achieving the optimal beam collimation even in conditions of changed brain anatomy. Integration of fMRI and navigated TMS into treatment planning may lead to reduction of motor complications after stereotactic radiosurgery.

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The authors declare that there are no conflicts of interest present.