Assessment of the influence of navigated transcranial magnetic stimulation on surgical planning for tumors in or near the motor cortex.

  title={Assessment of the influence of navigated transcranial magnetic stimulation on surgical planning for tumors in or near the motor cortex.},
  author={Thomas Picht and Juliane Schulz and Michael Hanna and Sein Schmidt and Olaf Suess and Peter Vajkoczy},
  volume={70 5},
          1248-56; discussion 1256-7
BACKGROUND Brain tumor surgery near the motor cortex requires careful planning to achieve the optimal balance between completeness of tumor resection and preservation of motor function. Navigated transcranial magnetic stimulation (nTMS) can be used to map functionally essential motor areas preoperatively. OBJECTIVE To evaluate how much influence, benefit, and impact nTMS has on the surgical planning for tumors near the motor cortex. METHODS This study reviewed the records of 73 patients… 

Navigated transcranial magnetic stimulation improves the treatment outcome in patients with brain tumors in motor eloquent locations.

BACKGROUND Neurological and oncological outcomes of motor eloquent brain-tumor patients depend upon the ability to localize functional areas and the respective proposed therapy. We set out to

The preoperative use of navigated transcranial magnetic stimulation facilitates early resection of suspected low-grade gliomas in the motor cortex

nTMS provides accurate motor mapping results also in infiltrative gliomas and enables more frequent and more extensive surgical resection of non-enhancing glioma in or near the primary motor cortex.

Preoperative Applications of Navigated Transcranial Magnetic Stimulation

This review aims to provide a comprehensive review of the role of nTMS in the neurosurgical management of a patient with a brain tumor and analyzes the evidence in support of the most common clinical applications.

Navigated transcranial magnetic stimulation for mapping the motor cortex in patients with rolandic brain tumors.

The nTMS technique spatially correlates well with the gold standard of DES and its functional information benefits surgical decision making and changes the treatment strategy in one-fourth of cases.

Preoperative motor mapping by navigated transcranial magnetic brain stimulation improves outcome for motor eloquent lesions.

Comparing patients with motor eloquently located supratentorial lesions investigated with or without preoperative nTMS in terms of clinical outcome parameters increases the level of evidence for preoperative motor mapping by nT MS for rolandic lesions in a group comparison study.

Risk stratification in motor area-related glioma surgery based on navigated transcranial magnetic stimulation data.

The proposed risk stratification model, based on objective functional-anatomical and neurophysiological measures, enables one to counsel patients about the risk of functional deterioration or the potential for recovery in glioma surgery.

Comparison of Navigated Transcranial Magnetic Stimulation to Direct Electrical Stimulation for Mapping the Motor Cortex Prior to Brain Tumor Resection

This chapter presents an overview of the possibilities and limitations of transcranial magnetic stimulation (TMS) and direct electrical stimulation (DES) for mapping of the cortical motor topography in the neurosurgical setting.



Navigated Transcranial Magnetic Stimulation and Functional Magnetic Resonance Imaging: Advanced Adjuncts in Preoperative Planning for Central Region Tumors

nTMS anticipates information usually only enabled by DCS and therefore allows surgical planning in eloquent cortex surgery, and is comparable to DCS in activating cortical pyramidal neurons.


nTMS allowed for reliable, precise application of the magnetic impulse, and the peritumoral somatotopy corresponded well between the 2 modalities in all 10 cases, indicating that nTMS is a promising method for preoperative functional mapping in motor cortex tumor surgery.

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

Peritumoral mapping of the motor cortex by nTMS agreed well with the gold standard of DCS, and is a reliable tool for preoperative mapping of motor function.

Assessment of functional MR imaging in neurosurgical planning.

Preoperative functional MR imaging is useful to clinicians at three key stages in the preoperative clinical management paradigm of a substantial percentage of patients who are being considered for resective tumor or epilepsy surgery.

Subcortical mapping and monitoring during insular tumor surgery.

A new method in which the descending motor pathways are monitored during surgery for insular tumors is presented, which allows a quantitative monitoring of motor function and functional mapping of the pyramidal tract during insular surgery.

Preoperative functional MR imaging localization of language and motor areas: effect on therapeutic decision making in patients with potentially resectable brain tumors.

Functional MR imaging enables the selection of a more aggressive therapeutic approach than might otherwise be considered because of functional risk.

Intraoperative electrocortical stimulation of Brodman area 4: a 10-year analysis of 255 cases

MCS must be considered a stimulation technique that enables reliable qualitative analysis of the recorded potentials, which may thus be regarded as directly predictive when using monopolar cortex stimulation for electrocortical mapping and continuous intraoperative neurophysiological monitoring.

Stereotactic transcranial magnetic stimulation: correlation with direct electrical cortical stimulation.

The findings indicate that stereotactic TMS is feasible and can provide accurate noninvasive localization of cortical motor function and may prove to be a useful method for presurgical planning.

Somatotopic blocking of sensation with navigated transcranial magnetic stimulation of the primary somatosensory cortex

It is found that TMS of a spatially restricted cortical S1 thenar area is sufficient to abolish sensation from a weak electric stimulation of the corresponding skin area and that with real‐time navigation, TMS can be repeatably directed at millimeter‐level precision to a target area defined on the MRI.

Navigated transcranial magnetic stimulation