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Language function shows comparable cortical patterns by functional MRI and repetitive nTMS in healthy volunteers

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Abstract

In preoperative planning, fMRI and repetitive navigated transcranial magnetic stimulation (rTMS) repeatedly revealed differences in the detected language sites, which can be attributed to tumor-induced oxygenation changes impairing the accuracy of fMRI. We therefore compared the accordance of those techniques in healthy subjects using exactly the same tasks in both investigations. 19 healthy right-handed subjects performed object naming, pseudoword reading, verb generation, and action naming during fMRI at 3 T and rTMS. For rTMS language mapping, we stimulated 46 cortical spots over the left hemisphere; each site was stimulated for three times. Language positive points during rTMS for one, two, or three errors out the three stimulations per spot (1/3, 2/3, 3/3) were exported via DICOM, and compared to the positive fMRI clusters. As a result of this comparison, the best correlation was observed between 3/3 errors and fMRI for pseudoword reading and verb generation with t-values of pu < 0.001, uncorrected for multiple comparisons, on average across the whole rTMS-spot map. We found a close spatial agreement between several rTMS-spots (2/3 and 3/3 errors) and fMRI clusters accentuated in the frontal lobe, followed by the parietal lobe and less in the temporal lobe. Compared to the fMRI clusters, there was a higher congruence for 2/3 and 3/3 errors than for 1/3 errors. Overall, results of language mapping in healthy subjects by fMRI and rTMS correspond well yet depending on the used language task.

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Abbreviations

aMTG:

Anterior middle temporal gyrus

CPS:

Cortical parcellation system

DCS:

Direct cortical stimulation

EEG:

Electroencephalography

EPI:

Echo planar imaging

fMRI:

Functional magnetic resonance imaging

GLM:

General linear model

ITG:

Inferior temporal gyrus

MEG:

Magnetoencephalography

NPV:

Negative predictive value

nTMS:

Navigated transcranial magnetic stimulation

orIFG:

Orbital part of the inferior frontal gyrus

PET:

Positron emission tomography

polIFG:

Polar inferior frontal gyrus

polMFG:

Polar middle frontal gyrus

polMTG:

Polar middle temporal gyrus

polSFG:

Polar superior frontal gyrus

polSTG:

Polar superior temporal gyrus

PTI:

Picture to trigger interval

RMT:

Resting Motor Threshold

rTMS:

Repetitive navigated transcranial magnetic stimulation

SEM:

Standard error of mean

VAS:

Visual analogue scale

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Funding

The study was financed by institutional grants from the Department of Neurosurgery and the Section of Neuroradiology.

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  1. Theresa Hauck, Monika Probst, Afra Wohlschlaeger and Sandro M. Krieg contributed equally to this work.

Authors and Affiliations

  1. Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany

    Theresa Hauck, Florian Ringel, Bernhard Meyer & Sandro M. Krieg

  2. Section of Neuroradiology, Department of Radiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany

    Monika Probst, Claus Zimmer & Afra Wohlschlaeger

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  1. Theresa Hauck
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  2. Monika Probst
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Correspondence to Sandro M. Krieg.

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SK, FR, and BM are consultants for Brainlab AG (Munich, Germany). SK is consultant for Nexstim Plc (Helsinki, Finland).

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Hauck, T., Probst, M., Zimmer, C. et al. Language function shows comparable cortical patterns by functional MRI and repetitive nTMS in healthy volunteers. Brain Imaging and Behavior 13, 1071–1092 (2019). https://doi.org/10.1007/s11682-018-9921-1

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