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Acta Neurochirurgica
Published in: Acta Neurochirurgica 7/2017

01-07-2017 | Review Article - Neurosurgical Techniques

Protocol for motor and language mapping by navigated TMS in patients and healthy volunteers; workshop report

Authors: Sandro M. Krieg, Pantelis Lioumis, Jyrki P. Mäkelä, Juha Wilenius, Jari Karhu, Henri Hannula, Petri Savolainen, Carolin Weiss Lucas, Kathleen Seidel, Aki Laakso, Mominul Islam, Selja Vaalto, Henri Lehtinen, Anne-Mari Vitikainen, Phiroz E. Tarapore, Thomas Picht

Published in: Acta Neurochirurgica | Issue 7/2017

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Abstract

Introduction

Navigated transcranial magnetic stimulation (nTMS) is increasingly used for preoperative mapping of motor function, and clinical evidence for its benefit for brain tumor patients is accumulating. In respect to language mapping with repetitive nTMS, literature reports have yielded variable results, and it is currently not routinely performed for presurgical language localization. The aim of this project is to define a common protocol for nTMS motor and language mapping to standardize its neurosurgical application and increase its clinical value.

Methods

The nTMS workshop group, consisting of highly experienced nTMS users with experience of more than 1500 preoperative nTMS examinations, met in Helsinki in January 2016 for thorough discussions of current evidence and personal experiences with the goal to recommend a standardized protocol for neurosurgical applications.

Results

nTMS motor mapping is a reliable and clinically validated tool to identify functional areas belonging to both normal and lesioned primary motor cortex. In contrast, this is less clear for language-eloquent cortical areas identified by nTMS. The user group agreed on a core protocol, which enables comparison of results between centers and has an excellent safety profile. Recommendations for nTMS motor and language mapping protocols and their optimal clinical integration are presented here.

Conclusion

At present, the expert panel recommends nTMS motor mapping in routine neurosurgical practice, as it has a sufficient level of evidence supporting its reliability. The panel recommends that nTMS language mapping be used in the framework of clinical studies to continue refinement of its protocol and increase reliability.
Appendix
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Metadata
Title
Protocol for motor and language mapping by navigated TMS in patients and healthy volunteers; workshop report
Authors
Sandro M. Krieg
Pantelis Lioumis
Jyrki P. Mäkelä
Juha Wilenius
Jari Karhu
Henri Hannula
Petri Savolainen
Carolin Weiss Lucas
Kathleen Seidel
Aki Laakso
Mominul Islam
Selja Vaalto
Henri Lehtinen
Anne-Mari Vitikainen
Phiroz E. Tarapore
Thomas Picht
Publication date
01-07-2017
Publisher
Springer Vienna
Published in
Acta Neurochirurgica / Issue 7/2017
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-017-3187-z

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