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Brain Imaging

Brain Imaging

Brain imaging technologies provide critical insights into both the structure and function of the human brain, enabling medical professionals and researchers to diagnose, study, and treat neurological disorders or psychiatric disorders more effectively.
These technologies include computerized axial tomography (CAT or CT scans), positron-emission tomography (PET scans), magnetic resonance imaging (MRI), functional magnetic resonance imaging (fMRI), and Transcranial Magnetic...

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Related Experiment Video

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Diffusion Tensor Magnetic Resonance Imaging in Chronic Spinal Cord Compression

Diffusion Tensor Magnetic Resonance Imaging in Chronic Spinal Cord Compression

Published on: May 7, 2019

TMS Seeded Diffusion Tensor Imaging Tractography Predicts Permanent Neurological Deficits.

Matthew Muir¹, Sarah Prinsloo¹, Hayley Michener¹

¹Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.

|January 21, 2022

Summary

Transcranial magnetic stimulation (TMS) combined with diffusion tensor imaging (DTI) tractography can predict postoperative neurological deficits in glioma patients. This approach helps surgeons balance maximal tumor resection with minimal neurological damage.

Keywords:

diffusion tensor imaging eloquence functional imaging glioma neurological deficit onco-functional balance tractography transcranial magnetic stimulation

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Last Updated: Oct 6, 2025

Diffusion Tensor Magnetic Resonance Imaging in Chronic Spinal Cord Compression

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DTI of the Visual Pathway - White Matter Tracts and Cerebral Lesions

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Published on: August 26, 2014

Area of Science:

Neurosurgery
Neuroscience
Medical Imaging

Background:

Optimizing the onco-functional balance in surgery requires maximizing resection while minimizing neurological deficits.
Preoperative identification of nonresectable structures is crucial for surgical planning.
Transcranial magnetic stimulation (TMS) noninvasively maps speech and motor systems, but its clinical utility in neurosurgery is not fully established.

Purpose of the Study:

To provide direct evidence on the clinical utility of TMS in neurosurgery by assessing the eloquence of TMS points.
To evaluate the predictive value of TMS, combined with diffusion tensor imaging (DTI) tractography, for postoperative neurological deficits in glioma patients.

Main Methods:

Retrospective study of 42 glioma patients.
Preoperative TMS mapping of speech and motor systems.
Postoperative MRI overlaid with preoperative MRI to visualize TMS points relative to the surgical cavity.
Diffusion tensor imaging (DTI) tractography to identify essential versus resectable TMS points.
Correlation of resected TMS points with 3-month postoperative motor function outcomes.

Main Results:

Resection of TMS-positive points was significantly predictive of permanent deficits (p=0.05).
Four out of eight patients with resected TMS-positive points experienced no permanent deficit, indicating variability.
DTI tractography at a 75% FA threshold effectively distinguished essential TMS points from those amenable to resection.
Combined TMS and DTI tractography demonstrated high positive and negative predictive values for postoperative neurological deficits.

Conclusions:

TMS, when integrated with DTI tractography, offers significant predictive power for postoperative neurological deficits in glioma surgery.
This combined approach aids surgeons in optimizing the onco-functional balance by identifying critical eloquent areas.
Further research is warranted to define the precise role of TMS in comprehensive pre-surgical mapping strategies.