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Navigated rTMS for Mapping the Language Network in Preoperative Settings: Current Status and Future Prospects

  • Abraham Tsitlakidis
  • Nicholas ForoglouEmail author
  • Maria Moschou
  • Evangelia Chatzikyriakou
  • Konstantinos Kouskouras
  • Ioannis Patsalas
  • Vasilios K. Kimiskidis
Chapter
  • 45 Downloads
Part of the Contemporary Clinical Neuroscience book series (CCNE)

Abstract

In an era that traditional localizationist models of brain organization lose ground and novel concepts of the organization of the language processing network at the level of the individual subject emerge, brain surgery can no longer rely on generic models of functional brain anatomy. Along with a range of established intraoperative neurophysiological mapping and monitoring techniques, navigated repetitive transcranial magnetic stimulation (nrTMS) has quite recently entered clinical practice as a noninvasive means to map the language network preoperatively. This novel technique is based on the phenomenon of electromagnetic induction, achieves functional mapping in a safe and well-tolerated manner, and produces results similar to those of intraoperative direct cortical stimulation (DCS) during awake craniotomy. The recent efforts to standardize its methodology, the overall positive results from its use, and the emerging advantages over other functional mapping techniques are expected to increase its adoption in clinical practice. Its substantial contribution in surgical planning, optimization of awake mapping, patient preparation, and counseling is already acknowledged in the neurosurgical community.

Keywords

Language Preoperative mapping Navigated brain stimulation Transcranial magnetic stimulation 

Abbreviations

DCS

Direct cortical stimulation

DTI

Diffusion tensor imaging

DWI

Diffusion-weighted imaging

EMG

Electromyography

FA

Fractional anisotropy

fMRI

Functional MRI

FT

Fiber tracking

MRI

Magnetic resonance imaging

nrTMS

Navigated rTMS

nTMS

Navigated TMS

rTMS

Repetitive TMS

TMS

Transcranial magnetic stimulation

μV

Microvolt(s)

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Further Reading

  1. Raffa, G., Quattropani, M. C., Scibilia, A., Conti, A., Angileri, F. F., Esposito, F., … Tomasello, F. (2018). Surgery of language-eloquent tumors in patients not eligible for awake surgery: The impact of a protocol based on navigated transcranial magnetic stimulation on presurgical planning and language outcome, with evidence of tumor-induced intra-hemispheric plasticity. Clinical Neurology and Neurosurgery, 168, 127–139.  https://doi.org/10.1016/j.clineuro.2018.03.009CrossRefPubMedGoogle Scholar
  2. Sollmann, N., Ille, S., Hauck, T., Maurer, S., Negwer, C., Zimmer, C., … Krieg, S. M. (2015). The impact of preoperative language mapping by repetitive navigated transcranial magnetic stimulation on the clinical course of brain tumor patients. BMC Cancer, 15, 261.  https://doi.org/10.1186/s12885-015-1299-5CrossRefPubMedPubMedCentralGoogle Scholar
  3. Tarapore, P. E., Findlay, A. M., Honma, S. M., Mizuiri, D., Houde, J. F., Berger, M. S., & Nagarajan, S. S. (2013). Language mapping with navigated repetitive TMS: Proof of technique and validation. NeuroImage, 82, 260–272.  https://doi.org/10.1016/j.neuroimage.2013.05.018CrossRefPubMedGoogle Scholar
  4. Tarapore, P. E., Picht, T., Bulubas, L., Shin, Y., Kulchytska, N., Meyer, B., … Krieg, S. M. (2016). Safety and tolerability of navigated TMS for preoperative mapping in neurosurgical patients. Clinical Neurophysiology, 127(3), 1895–1900.  https://doi.org/10.1016/j.clinph.2015.11.042CrossRefPubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Abraham Tsitlakidis
    • 1
  • Nicholas Foroglou
    • 1
    Email author
  • Maria Moschou
    • 2
  • Evangelia Chatzikyriakou
    • 2
  • Konstantinos Kouskouras
    • 3
  • Ioannis Patsalas
    • 1
  • Vasilios K. Kimiskidis
    • 2
  1. 1.1st Department of Neurosurgery, AHEPA University HospitalAristotle University of ThessalonikiThessalonikiGreece
  2. 2.Laboratory of Clinical Neurophysiology, AHEPA University HospitalAristotle University of ThessalonikiThessalonikiGreece
  3. 3.Radiology Department, AHEPA University HospitalAristotle University of ThessalonikiThessalonikiGreece

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