ИСТИНА

Background: Since 90-ies of the 20th century direct bipolar electrical stimulation has been the golden standard of intraoperative identification motor eloquent areas. Later, monopolar stimulation has been introduced into clinical practice. Today, there is no common opinion on which one technique is the best. Objective: To compare the motor threshold, frequency of positive motor responses and activated muscle groups for monopolar and bipolar mapping in same points. Materials and methods: This prospective study enrolled 10 patients with supratentorial tumors of different histological types located close to motor eloquent areas. Surgery was performed with combined monopolar and bipolar mapping (56 points). The comparative data analysis of monopolar and bipolar stimulation in same points included: motor threshold correlations, frequency of positive motor responses and activated muscle groups. Results: There is no statistically significant difference between monolar and bipolar stimulation in frequency of positive motor responses and the number of the activated muscle groups (p=0.05). Motor threshold is evidently lower in monopolar stimulation (7 mA versus 10 mA, p=0.02). Motor threshold is below 3 mA in patients with postoperative hemiparesis (4 cases). Conclusions: Monopolar stimulation is the reliable method of continuous dynamic mapping motor eloquent areas.By a Grant from the Russian Foundation for Basic Research: Mk 19-29-01154 “Predicting of pyramidal symptoms and its reversibility in patients with supratentorial glial tumors located near the motor areas, using the knowledge transfer method and deep neural networks based on multifactor analysis of digital data of different modality”.