T Picht1. 1. Neurochirurgische Klinik, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Deutschland. thomas.picht@charite.de.
Abstract
BACKGROUND: Brain tumor surgery in functionally relevant areas is particularly challenging. Preoperative functional mapping with navigated transcranial magnetic stimulation (TMS) was introduced into the clinical routine in 2009 and since then has seen widespread adoption. OBJECTIVES: Accuracy and consistency of TMS motor and language mapping and its clinical relevance. METHODS: Analysis of published scientific papers and discussion of the findings. RESULTS: Positive (i.e. motor responses are elicited) and negative cortical points for TMS motor mapping can be used for treatment planning and intraoperative decision making. Language mapping points (disruption of language function) positive in TMS can support treatment planning but should be confirmed intraoperatively with direct electrical stimulation. Negative TMS language mapping (language functions are not disrupted) correlates well with the gold standard of intraoperative testing. Recent studies reported improved treatment outcome after preoperative TMS mapping. CONCLUSION: Patients suffering from brain tumors in eloquent locations should be counseled based on individual functional mapping data before surgery and TMS is a valid non-invasive methodology which can provide such functional mapping.
BACKGROUND:Brain tumor surgery in functionally relevant areas is particularly challenging. Preoperative functional mapping with navigated transcranial magnetic stimulation (TMS) was introduced into the clinical routine in 2009 and since then has seen widespread adoption. OBJECTIVES: Accuracy and consistency of TMS motor and language mapping and its clinical relevance. METHODS: Analysis of published scientific papers and discussion of the findings. RESULTS: Positive (i.e. motor responses are elicited) and negative cortical points for TMS motor mapping can be used for treatment planning and intraoperative decision making. Language mapping points (disruption of language function) positive in TMS can support treatment planning but should be confirmed intraoperatively with direct electrical stimulation. Negative TMS language mapping (language functions are not disrupted) correlates well with the gold standard of intraoperative testing. Recent studies reported improved treatment outcome after preoperative TMS mapping. CONCLUSION:Patients suffering from brain tumors in eloquent locations should be counseled based on individual functional mapping data before surgery and TMS is a valid non-invasive methodology which can provide such functional mapping.
Entities:
Keywords:
Brain mapping; Brain tumor; Language mapping; Navigated transcranial magnetic stimulation; Noninvasive mapping
Authors: Pantelis Lioumis; Andrey Zhdanov; Niko Mäkelä; Henri Lehtinen; Juha Wilenius; Tuomas Neuvonen; Henri Hannula; Vedran Deletis; Thomas Picht; Jyrki P Mäkelä Journal: J Neurosci Methods Date: 2011-11-15 Impact factor: 2.390
Authors: Philip C De Witt Hamer; Santiago Gil Robles; Aeilko H Zwinderman; Hugues Duffau; Mitchel S Berger Journal: J Clin Oncol Date: 2012-04-23 Impact factor: 44.544
Authors: Thomas Picht; Sein Schmidt; Stephan Brandt; Dietmar Frey; Henri Hannula; Tuomas Neuvonen; Jari Karhu; Peter Vajkoczy; Olaf Suess Journal: Neurosurgery Date: 2011-09 Impact factor: 4.654