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Related Concept Videos

Brain Imaging01:14

Brain Imaging

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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

Updated: Aug 16, 2025

Study Design for Navigated Repetitive Transcranial Magnetic Stimulation for Speech Cortical Mapping
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Study Design for Navigated Repetitive Transcranial Magnetic Stimulation for Speech Cortical Mapping

Published on: March 24, 2023

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Tractography-based navigated TMS language mapping protocol.

Klara Reisch1, Franziska Böttcher1, Mehmet S Tuncer1

  • 1Image Guidance Lab, Department of Neurosurgery, Charité - University Hospital, Berlin, Germany.

Frontiers in Oncology
|December 26, 2022
PubMed
Summary
This summary is machine-generated.

This study shows that targeting the arcuate fasciculus (AF) with navigated transcranial magnetic stimulation (nTMS) improves language mapping accuracy. This tractography-based nTMS protocol enhances disruption of object naming compared to standard methods.

Keywords:
diffusion magnetic resonance imaginggliomalanguage mappingpreoperative planningtractographytranscranial magnetic stimulation

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Area of Science:

  • Neuroscience
  • Neurosurgery
  • Medical Imaging

Background:

  • Navigated transcranial magnetic stimulation (nTMS) is crucial for presurgical language mapping.
  • Established perisylvian nTMS protocols lack specific white matter tract targeting.
  • The arcuate fasciculus (AF) is a key component of the language network.

Purpose of the Study:

  • To evaluate the feasibility and efficacy of a novel tractography-based nTMS protocol targeting AF cortical terminations.
  • To compare language mapping results and error distribution between the new protocol and a standard perisylvian nTMS protocol.

Main Methods:

  • Sixty patients with brain tumors underwent nTMS language mapping.
  • One cohort received a tractography-based protocol targeting AF endpoints; the other received a standard perisylvian protocol.
  • Probabilistic tractography identified AF cortical endpoints, and language errors were classified.

Main Results:

  • The tractography-based AF protocol yielded significantly higher overall error rates (ER) than the perisylvian protocol (3.8% vs. 2.9%).
  • Higher median ERs without hesitation errors were observed in the tractography-based group (2.0% vs. 1.4%).
  • Distinct cortical regions showed high ERs for each protocol, with the tractography-based method highlighting middle/ventral postcentral gyrus and opercular/ventral precentral gyrus.

Conclusions:

  • Tractography-guided nTMS targeting AF cortical endpoints increases the efficacy of language disruption.
  • This novel approach provides proof of concept for AF-specific language mapping.
  • Future studies can extend this method to other language network fiber bundles.