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

Area of Science:

• Neurosurgery
• Cognitive Neuroscience
• Neuroimaging

Background:

• Accurate presurgical mapping of speech areas is crucial for patients undergoing brain surgery.
• Current invasive methods like direct cortical stimulation (DCS) have limitations.
• Non-invasive imaging techniques can identify speech regions but not their critical function.

Purpose of the Study:

• To detail a protocol for non-invasive speech cortical mapping (SCM) using navigated repetitive transcranial magnetic stimulation (nrTMS).
• To provide an alternative to invasive mapping for presurgical planning.
• To enable preoperative assessment of speech area criticality.

Main Methods:

• Utilizes repetitive transcranial magnetic stimulation (rTMS) to induce speech errors non-invasively.
• Integrates rTMS with neuronavigation (nrTMS) for precise cortical stimulation.
• Provides a detailed protocol adaptable for patient-specific needs.

Main Results:

• nrTMS can elicit speech-related errors, similar to intraoperative DCS.
• This allows neurosurgeons to preoperatively assess critical speech areas.
• The protocol facilitates planning to preserve language function during surgery.

Conclusions:

• Navigated repetitive transcranial magnetic stimulation (nrTMS) offers a reliable non-invasive method for speech cortical mapping (SCM).
• This technique aids in surgical planning for brain tumors and epilepsy, reducing risks and costs.
• The protocol can also be used for language network studies in various patient populations.