Related Experiment Video
Updated: Jun 2, 2026
A Standardized Protocol for Functional Motor Mapping Using Navigated Transcranial Magnetic Stimulation
Published on: February 27, 2026
Navigated transcranial magnetic stimulation-guided resection of a left parietal tumor: case report
J Coburger1, C Musahl, C Weissbach
1Department of Neurosurgery, Klinikum Stuttgart, Stuttgart, Germany. J.Coburger@klinikum-stuttgart.de
Background:
Operating on tumors with close margins to the primary motor cortex requires a precise preoperative planning. Transcranial magnetic stimulation (TMS) is the only preoperative technique for detecting eloquent cortical regions that is directly comparable to direct cortical stimulation (DCS). Combining this well established method in neurological diagnostics with a non-invasive navigation system using the patient's preoperative MRI scans in the NEXTSTIM system might be a promising tool in preoperative planning.
Case Report:
We used preoperative navigated TMS to localize the motor strip in a 75-year-old female patient with a central lesion suspected to be a meningeoma. The elicited data were fused to the navigation MRI in the Brainlab IPLAN system. Following the preoperatively acquired MEP data, a posterior approach to the tumor was planned. After craniotomy, DCS and phase reversal were performed to verify the preoperative results. The motor strip could be located in the same cortical area where the motor response was elicited preoperatively.
Conclusion:
Navigated transcranial cortical stimulation via the NEXTSTIM system is a helpful tool for preoperative planning.
Insights
Navigated transcranial magnetic stimulation (TMS) precisely mapped a patient's motor cortex before surgery. This non-invasive technique aids in planning tumor resections near eloquent brain areas.
Area of Science:
- Neurosurgery
- Neurology
- Medical Imaging
Background:
- Precise preoperative planning is crucial for surgeries near the primary motor cortex.
- Transcranial magnetic stimulation (TMS) is a key non-invasive technique for mapping eloquent cortical regions.
- Integrating TMS with non-invasive navigation systems like NEXTSTIM offers potential for enhanced surgical planning.
Observation:
- Navigated TMS was employed to localize the motor strip in a patient with a central lesion.
- Data from TMS was fused with preoperative MRI scans using the Brainlab IPLAN system.
- A surgical approach was planned based on the preoperatively acquired motor evoked potential (MEP) data.
Findings:
- Direct cortical stimulation (DCS) during surgery confirmed the motor strip location identified by navigated TMS.
- The navigated TMS accurately predicted the cortical area corresponding to motor responses.
Implications:
- Navigated TMS, utilizing systems like NEXTSTIM, proves to be a valuable tool for preoperative surgical planning.
- This technology can improve surgical accuracy and patient outcomes for brain tumor resections near critical motor areas.
