Repeated mapping of cortical language sites by preoperative navigated transcranial magnetic stimulation compared to repeated intraoperative DCS mapping in awake craniotomy

BMC Neuroscience

Florian Ringel¹  Bernhard Meyer¹  Sebastian Ille¹  Theresa Hauck¹  Nico Sollmann¹  Sandro M Krieg¹ 

[1]Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, Munich, 81675, Germany

关键词: Navigated brain stimulation;    Transcranial magnetic stimulation;    Tumor;    Broca’s area;    Preoperative mapping;   

Others  :  1122560
DOI  :  10.1186/1471-2202-15-20

 received in 2013-05-18, accepted in 2014-01-17,  发布年份 2014

【 摘 要 】

Background

Repetitive navigated transcranial magnetic stimulation (rTMS) was recently described for mapping of human language areas. However, its capability of detecting language plasticity in brain tumor patients was not proven up to now. Thus, this study was designed to evaluate such data in order to compare rTMS language mapping to language mapping during repeated awake surgery during follow-up in patients suffering from language-eloquent gliomas.

Methods

Three right-handed patients with left-sided gliomas (2 opercular glioblastomas, 1 astrocytoma WHO grade III of the angular gyrus) underwent preoperative language mapping by rTMS as well as intraoperative language mapping provided via direct cortical stimulation (DCS) for initial as well as for repeated Resection 7, 10, and 15 months later.

Results

Overall, preoperative rTMS was able to elicit clear language errors in all mappings. A good correlation between initial rTMS and DCS results was observed. As a consequence of brain plasticity, initial DCS and rTMS findings only corresponded with the results obtained during the second examination in one out of three patients thus suggesting changes of language organization in two of our three patients.

Conclusions

This report points out the usefulness but also the limitations of preoperative rTMS language mapping to detect plastic changes in language function or for long-term follow-up prior to DCS even in recurrent gliomas. However, DCS still has to be regarded as gold standard.

【 授权许可】

   
2014 Krieg et al.; licensee BioMed Central Ltd.

【 图 表 】

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