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

被引:150
作者
Krieg, Sandro M. [1 ]
Lioumis, Pantelis [2 ,3 ]
Makela, Jyrki P. [2 ,3 ]
Wilenius, Juha [3 ,4 ]
Karhu, Jari [5 ]
Hannula, Henri [5 ,6 ]
Savolainen, Petri [5 ]
Lucas, Carolin Weiss [7 ]
Seidel, Kathleen [8 ]
Laakso, Aki [9 ,10 ]
Islam, Mominul [11 ]
Vaalto, Selja [3 ,4 ]
Lehtinen, Henri [12 ]
Vitikainen, Anne-Mari [2 ,3 ]
Tarapore, Phiroz E. [13 ]
Picht, Thomas [14 ]
机构
[1] Tech Univ, Klinikum Rechts Isar, Dept Neurosurg, Ismaninger Str 22, D-81675 Munich, Germany
[2] Univ Helsinki, HUS Med Imaging Ctr, BioMag Lab, POB 340, Helsinki 00029, Finland
[3] Helsinki Univ Hosp, POB 340, Helsinki 00029, Finland
[4] Univ Helsinki, HUS Med Imaging Ctr, Dept Clin Neurophysiol, POB 340, Helsinki 00029, Finland
[5] Nexstim Plc, Elimaenkatu 9 B, Helsinki 00510, Finland
[6] Aalto Univ, Dept Biomed Engn & Computat Sci, Espoo, Finland
[7] Univ Hosp Cologne, Ctr Neurosurg, Kerpener Str 62, D-50937 Cologne, Germany
[8] Univ Bern, Univ Hosp Bern, Inselspital, Dept Neurosurg, CH-3010 Bern, Switzerland
[9] Helsinki Univ Hosp, Dept Neurosurg, POB 266,Topeliuksenkatu 5, Helsinki 00260, Finland
[10] Univ Helsinki, Clin Neurosci, Neurosurg, POB 266,Topeliuksenkatu 5, Helsinki 00260, Finland
[11] Karolinska Univ Hosp, Dept Clin Neurophysiol R2 01, S-17176 Stockholm, Sweden
[12] Univ Helsinki, Cent Hosp, Dept Pediat Neurol, Epilepsy Unit, Lastenlinnantie 2 PL 280, Helsinki 00029, Finland
[13] Univ Calif San Francisco, Dept Neurol Surg, 505 Parnassus Ave, San Francisco, CA 94143 USA
[14] Charite Univ Med Berlin, Dept Neurosurg, Campus Benjamin Franklin,Augustenburger Pl 1, D-13353 Berlin, Germany
关键词
Brain tumor; Epilepsy surgery; Motor; Language; Preoperative mapping; Transcranial magnetic stimulation; TRANSCRANIAL MAGNETIC STIMULATION; BRAIN-STIMULATION; NEUROSURGICAL PATIENTS; CORTICAL STIMULATION; CORTICOSPINAL TRACT; NAMING ERRORS; HAND AREA; RESECTION; SPEECH; NTMS;
D O I
10.1007/s00701-017-3187-z
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
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. 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. 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. 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.
引用
收藏
页码:1187 / 1195
页数:9
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