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Bilateral Assessment of the Corticospinal Pathways of the Ankle Muscles Using Navigated Transcranial Magnetic Stimulation
Published on: February 19, 2019
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Identifying functional cortical plasticity after spinal tumour resection using navigated transcranial magnetic
L Onyiriuka1, J M Aliaga-Arias1,2, S Patel1,3
1King's College Hospital NHS Foundation Trust, UK.
Annals of the Royal College of Surgeons of England
|July 4, 2024
Summary
Navigated transcranial magnetic stimulation (nTMS) effectively maps motor deficits from spinal tumors. Post-surgery, nTMS shows functional brain reorganization and improved patient outcomes.
Area of Science:
- Neurosurgery
- Neuroscience
- Medical Imaging
Background:
- Intradural extramedullary (IDEM) tumors can cause significant preoperative motor impairment.
- Assessing motor deficits and postoperative functional recovery is crucial for patient management.
Purpose of the Study:
- To evaluate navigated transcranial magnetic stimulation (nTMS) for characterizing preoperative motor deficits caused by IDEM tumors.
- To assess nTMS's ability to track postoperative cortical functional reorganization.
Main Methods:
- A case study involving a patient with a thoracic spinal meningioma.
- Preoperative and 1-year follow-up clinical, radiological, and nTMS data were collected and compared.
- nTMS motor mapping was used to assess cortical activation areas and volumes.
Main Results:
- Preoperatively, nTMS showed bilateral upper limb representation but no lower limb responses.
- Postoperatively, nTMS documented positive responses for both upper and lower limbs.
- A significant decrease in cortical activation area and volume for upper limbs was observed, indicating functional reorganization.
Conclusions:
- nTMS motor mapping is effective in characterizing preoperative motor deficits associated with IDEM tumors.
- nTMS can successfully monitor cortical plasticity and functional reorganization during follow-up after IDEM tumor resection.
