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Preoperative Functional Mapping for Rolandic Brain Tumor Surgery: Comparison of Navigated Transcranial Magnetic Stimulation to Direct Cortical Stimulation

Abstract BACKGROUND: Transcranial magnetic stimulation (TMS) is the only noninvasive method for presurgical stimulation mapping of cortical function. Recent technical advancements have significantly increased the focality and usability of the method. OBJECTIVE: To compare the accuracy of a 3-dimensi... Full description

Journal Title: Neurosurgery 2011, Vol.69 (3), p.581-589
Main Author: Picht, Thomas
Other Authors: Schmidt, Sein , Brandt, Stephan , Frey, Dietmar , Hannula, Henri , Neuvonen, Tuomas , Karhu, Jari , Vajkoczy, Peter , Suess, Olaf
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: Hagerstown, MD: Oxford University Press
ID: ISSN: 0148-396X
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title: Preoperative Functional Mapping for Rolandic Brain Tumor Surgery: Comparison of Navigated Transcranial Magnetic Stimulation to Direct Cortical Stimulation
format: Article
creator:
  • Picht, Thomas
  • Schmidt, Sein
  • Brandt, Stephan
  • Frey, Dietmar
  • Hannula, Henri
  • Neuvonen, Tuomas
  • Karhu, Jari
  • Vajkoczy, Peter
  • Suess, Olaf
subjects:
  • Adult
  • Aged
  • Aged, 80 and over
  • Anesthesia, General
  • Anticonvulsants - therapeutic use
  • Biological and medical sciences
  • Brain cancer
  • Brain Mapping - methods
  • Brain Neoplasms - complications
  • Brain Neoplasms - surgery
  • Deep Brain Stimulation
  • Electric Stimulation - methods
  • Epilepsy, Rolandic - complications
  • Epilepsy, Rolandic - etiology
  • Epilepsy, Rolandic - surgery
  • Female
  • Hemispherectomy - methods
  • Humans
  • Image Processing, Computer-Assisted
  • Imaging, Three-Dimensional
  • Male
  • Medical sciences
  • Middle Aged
  • Motor Cortex - pathology
  • Motor Cortex - physiopathology
  • Motor Cortex - surgery
  • Neuronavigation - methods
  • Neurosurgery
  • Neurosurgical Procedures
  • Patient Selection
  • Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
  • Transcranial magnetic stimulation
  • Transcranial Magnetic Stimulation - methods
ispartof: Neurosurgery, 2011, Vol.69 (3), p.581-589
description: Abstract BACKGROUND: Transcranial magnetic stimulation (TMS) is the only noninvasive method for presurgical stimulation mapping of cortical function. Recent technical advancements have significantly increased the focality and usability of the method. OBJECTIVE: To compare the accuracy of a 3-dimensional magnetic resonance imaging-navigated TMS system (nTMS) with the gold standard of direct cortical stimulation (DCS). METHODS: The primary motor areas of 20 patients with rolandic tumors were mapped preoperatively with nTMS at 110% of the individual resting motor threshold. Intraoperative DCS was available from 17 patients. The stimulus locations eliciting the largest electromyographic response in the target muscles (“hotspots”) were determined for both methods. RESULTS: The nTMS and DCS hotspots were located on the same gyrus in all cases. The mean ± SEM distance between the nTMS and DCS hotspots was 7.83 ± 1.18 mm for the abductor pollicis brevis (APB) muscle (n = 15) and 7.07 ± 0.88 mm for the tibialis anterior muscle (n = 8). When a low number of DCS stimulations was performed, the distance between the nTMS and DCS hotspots increased substantially (r = −0.86 for APB). After the exclusion of the cases with < 15 DCS APB responses, the mean ± SEM distance between the hotspots was only 4.70 ± 1.09 mm for APB (n = 8). CONCLUSION: Peritumoral mapping of the motor cortex by nTMS agreed well with the gold standard of DCS. Thus, nTMS is a reliable tool for preoperative mapping of motor function.
language: eng
source:
identifier: ISSN: 0148-396X
fulltext: no_fulltext
issn:
  • 0148-396X
  • 1524-4040
url: Link


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titlePreoperative Functional Mapping for Rolandic Brain Tumor Surgery: Comparison of Navigated Transcranial Magnetic Stimulation to Direct Cortical Stimulation
creatorPicht, Thomas ; Schmidt, Sein ; Brandt, Stephan ; Frey, Dietmar ; Hannula, Henri ; Neuvonen, Tuomas ; Karhu, Jari ; Vajkoczy, Peter ; Suess, Olaf
creatorcontribPicht, Thomas ; Schmidt, Sein ; Brandt, Stephan ; Frey, Dietmar ; Hannula, Henri ; Neuvonen, Tuomas ; Karhu, Jari ; Vajkoczy, Peter ; Suess, Olaf
descriptionAbstract BACKGROUND: Transcranial magnetic stimulation (TMS) is the only noninvasive method for presurgical stimulation mapping of cortical function. Recent technical advancements have significantly increased the focality and usability of the method. OBJECTIVE: To compare the accuracy of a 3-dimensional magnetic resonance imaging-navigated TMS system (nTMS) with the gold standard of direct cortical stimulation (DCS). METHODS: The primary motor areas of 20 patients with rolandic tumors were mapped preoperatively with nTMS at 110% of the individual resting motor threshold. Intraoperative DCS was available from 17 patients. The stimulus locations eliciting the largest electromyographic response in the target muscles (“hotspots”) were determined for both methods. RESULTS: The nTMS and DCS hotspots were located on the same gyrus in all cases. The mean ± SEM distance between the nTMS and DCS hotspots was 7.83 ± 1.18 mm for the abductor pollicis brevis (APB) muscle (n = 15) and 7.07 ± 0.88 mm for the tibialis anterior muscle (n = 8). When a low number of DCS stimulations was performed, the distance between the nTMS and DCS hotspots increased substantially (r = −0.86 for APB). After the exclusion of the cases with < 15 DCS APB responses, the mean ± SEM distance between the hotspots was only 4.70 ± 1.09 mm for APB (n = 8). CONCLUSION: Peritumoral mapping of the motor cortex by nTMS agreed well with the gold standard of DCS. Thus, nTMS is a reliable tool for preoperative mapping of motor function.
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subjectAdult ; Aged ; Aged, 80 and over ; Anesthesia, General ; Anticonvulsants - therapeutic use ; Biological and medical sciences ; Brain cancer ; Brain Mapping - methods ; Brain Neoplasms - complications ; Brain Neoplasms - surgery ; Deep Brain Stimulation ; Electric Stimulation - methods ; Epilepsy, Rolandic - complications ; Epilepsy, Rolandic - etiology ; Epilepsy, Rolandic - surgery ; Female ; Hemispherectomy - methods ; Humans ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional ; Male ; Medical sciences ; Middle Aged ; Motor Cortex - pathology ; Motor Cortex - physiopathology ; Motor Cortex - surgery ; Neuronavigation - methods ; Neurosurgery ; Neurosurgical Procedures ; Patient Selection ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Transcranial magnetic stimulation ; Transcranial Magnetic Stimulation - methods
ispartofNeurosurgery, 2011, Vol.69 (3), p.581-589
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1Schmidt, Sein
2Brandt, Stephan
3Frey, Dietmar
4Hannula, Henri
5Neuvonen, Tuomas
6Karhu, Jari
7Vajkoczy, Peter
8Suess, Olaf
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descriptionAbstract BACKGROUND: Transcranial magnetic stimulation (TMS) is the only noninvasive method for presurgical stimulation mapping of cortical function. Recent technical advancements have significantly increased the focality and usability of the method. OBJECTIVE: To compare the accuracy of a 3-dimensional magnetic resonance imaging-navigated TMS system (nTMS) with the gold standard of direct cortical stimulation (DCS). METHODS: The primary motor areas of 20 patients with rolandic tumors were mapped preoperatively with nTMS at 110% of the individual resting motor threshold. Intraoperative DCS was available from 17 patients. The stimulus locations eliciting the largest electromyographic response in the target muscles (“hotspots”) were determined for both methods. RESULTS: The nTMS and DCS hotspots were located on the same gyrus in all cases. The mean ± SEM distance between the nTMS and DCS hotspots was 7.83 ± 1.18 mm for the abductor pollicis brevis (APB) muscle (n = 15) and 7.07 ± 0.88 mm for the tibialis anterior muscle (n = 8). When a low number of DCS stimulations was performed, the distance between the nTMS and DCS hotspots increased substantially (r = −0.86 for APB). After the exclusion of the cases with < 15 DCS APB responses, the mean ± SEM distance between the hotspots was only 4.70 ± 1.09 mm for APB (n = 8). CONCLUSION: Peritumoral mapping of the motor cortex by nTMS agreed well with the gold standard of DCS. Thus, nTMS is a reliable tool for preoperative mapping of motor function.
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3Anesthesia, General
4Anticonvulsants - therapeutic use
5Biological and medical sciences
6Brain cancer
7Brain Mapping - methods
8Brain Neoplasms - complications
9Brain Neoplasms - surgery
10Deep Brain Stimulation
11Electric Stimulation - methods
12Epilepsy, Rolandic - complications
13Epilepsy, Rolandic - etiology
14Epilepsy, Rolandic - surgery
15Female
16Hemispherectomy - methods
17Humans
18Image Processing, Computer-Assisted
19Imaging, Three-Dimensional
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22Middle Aged
23Motor Cortex - pathology
24Motor Cortex - physiopathology
25Motor Cortex - surgery
26Neuronavigation - methods
27Neurosurgery
28Neurosurgical Procedures
29Patient Selection
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32Transcranial Magnetic Stimulation - methods
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authorPicht, Thomas ; Schmidt, Sein ; Brandt, Stephan ; Frey, Dietmar ; Hannula, Henri ; Neuvonen, Tuomas ; Karhu, Jari ; Vajkoczy, Peter ; Suess, Olaf
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1Aged
2Aged, 80 and over
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8Brain Neoplasms - complications
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28Neurosurgical Procedures
29Patient Selection
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atitlePreoperative Functional Mapping for Rolandic Brain Tumor Surgery: Comparison of Navigated Transcranial Magnetic Stimulation to Direct Cortical Stimulation
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abstractAbstract BACKGROUND: Transcranial magnetic stimulation (TMS) is the only noninvasive method for presurgical stimulation mapping of cortical function. Recent technical advancements have significantly increased the focality and usability of the method. OBJECTIVE: To compare the accuracy of a 3-dimensional magnetic resonance imaging-navigated TMS system (nTMS) with the gold standard of direct cortical stimulation (DCS). METHODS: The primary motor areas of 20 patients with rolandic tumors were mapped preoperatively with nTMS at 110% of the individual resting motor threshold. Intraoperative DCS was available from 17 patients. The stimulus locations eliciting the largest electromyographic response in the target muscles (“hotspots”) were determined for both methods. RESULTS: The nTMS and DCS hotspots were located on the same gyrus in all cases. The mean ± SEM distance between the nTMS and DCS hotspots was 7.83 ± 1.18 mm for the abductor pollicis brevis (APB) muscle (n = 15) and 7.07 ± 0.88 mm for the tibialis anterior muscle (n = 8). When a low number of DCS stimulations was performed, the distance between the nTMS and DCS hotspots increased substantially (r = −0.86 for APB). After the exclusion of the cases with < 15 DCS APB responses, the mean ± SEM distance between the hotspots was only 4.70 ± 1.09 mm for APB (n = 8). CONCLUSION: Peritumoral mapping of the motor cortex by nTMS agreed well with the gold standard of DCS. Thus, nTMS is a reliable tool for preoperative mapping of motor function.
copHagerstown, MD
pubOxford University Press
pmid21430587
doi10.1227/NEU.0b013e3182181b89