Intra-operative Acquisition of Electrophysiological Data in Human Motor Eloquent Neurosurgery v1

Problem: When acquiring intra-operative subcortical stimulation data, it is important to account for the spatial inaccuracies that may be introduced due to a spatial mismatch between pre-operative imaging and the location of the brain after resection. Phenomena such as brain shift contribute to the discrepancy between where the intra-operative stimulation points lie on pre-operative MR images and where the stimulations points lie on intra-operative MR images. This protocol aims to correct for this discrepancy when acquiring intra-operative stimulation data without the need for time-expensive intra-operative MRI. Furthermore, this protocols aims to increase transparency in the employed methods to encourage replication studies. Aim: If followed correctly, the protocol will result in a data set of electrophysiological data, based on motor evoked potentials, obtained during surgery of motor eloquent lesions. Specifically, the data can be used to assess the distance between the subcortical stimulation point and the corticospinal tract. This distance is corrected for brain shift. Suitable patients are adult patients (≥18 years) with a motor eloquent pathology. Innovation: This protocol stands apart from other procedures because it employs intra-operative ultrasound to correct for spatial shifts of the brain that occur during or after resection. Furthermore, this protocol is designed to pose minimal interference with the standard operating procedures in neurosurgery. Pre-requisites: This protocol assumes familiarity with conducting intra-operative neuromonitoring.