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Utilizing Repetitive Transcranial Magnetic Stimulation to Improve Language Function in Stroke Patients with Chronic Non-fluent Aphasia
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Language function shows comparable cortical patterns by functional MRI and repetitive nTMS in healthy volunteers
Theresa Hauck1, Monika Probst2, Claus Zimmer2
1Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
Brain Imaging and Behavior
|July 8, 2018
Summary
Functional MRI (fMRI) and repetitive navigated transcranial magnetic stimulation (rTMS) show good agreement for language mapping in healthy individuals. The best correlation was found for pseudoword reading and verb generation tasks, with higher accuracy using stricter rTMS error thresholds.
Area of Science:
- Neuroscience
- Cognitive Neuroscience
- Neurology
Background:
- Functional magnetic resonance imaging (fMRI) and repetitive navigated transcranial magnetic stimulation (rTMS) are crucial for preoperative language mapping.
- Tumor-induced oxygenation changes can affect fMRI accuracy, necessitating comparison with other techniques like rTMS.
- Previous studies have shown discrepancies between fMRI and rTMS language site detection.
Purpose of the Study:
- To compare the accordance of fMRI and rTMS for language mapping in healthy subjects.
- To evaluate the influence of different language tasks on the agreement between fMRI and rTMS.
- To determine the optimal rTMS stimulation error threshold for accurate language site identification.
Main Methods:
- 19 healthy right-handed subjects underwent both fMRI and rTMS language mapping using identical tasks (object naming, pseudoword reading, verb generation, action naming).
- rTMS involved stimulating 46 cortical spots in the left hemisphere, with language sites identified based on 1, 2, or 3 errors out of three stimulations per spot (1/3, 2/3, 3/3).
- fMRI data and rTMS-identified language-positive points were spatially compared.
Main Results:
- A strong correlation was observed between fMRI and rTMS for pseudoword reading and verb generation tasks, particularly with the 3/3 error threshold (p<0.001, uncorrected).
- Close spatial agreement between rTMS spots (2/3 and 3/3 errors) and fMRI clusters was noted, predominantly in the frontal lobe, followed by parietal and temporal lobes.
- Higher congruence was found for 2/3 and 3/3 rTMS error thresholds compared to the 1/3 threshold.
Conclusions:
- fMRI and rTMS demonstrate good correspondence for language mapping in healthy subjects.
- The agreement between fMRI and rTMS is task-dependent, with pseudoword reading and verb generation showing the best results.
- Stricter error criteria (2/3 and 3/3 errors) in rTMS enhance the congruence with fMRI language mapping.
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