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Language Mapping With rTMS in Healthy Pediatric Patients.

Kishore Vedala1,2, Darren S Kadis3,4, Jennifer Vannest5

  • 1Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, U.S.A.

Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society
|January 29, 2025
PubMed
Summary

Repetitive transcranial magnetic stimulation (rTMS) can identify language sites in children, showing weak left lateralization for visual naming. This noninvasive method is useful but not sufficient alone for preoperative language mapping in pediatric patients.

Keywords:
Language mappingPediatricsRepetitive transcranial magnetic stimulation

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Area of Science:

  • Neuroscience
  • Cognitive Science
  • Medical Imaging

Background:

  • Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive brain stimulation technique.
  • Language mapping is crucial for neurosurgical planning, especially in pediatric patients.
  • Existing data on rTMS for language mapping in children is limited.

Purpose of the Study:

  • To investigate the efficacy of navigated rTMS for language mapping in healthy pediatric participants.
  • To determine language lateralization during specific cognitive tasks in children.

Main Methods:

  • Bilateral language mapping was performed on 34 children (aged 5-18) using navigated rTMS.
  • Stimulation was applied during visual-naming and auditory verb-generation tasks.
  • Language lateralization was assessed using the lateralization index (LI) and statistical modeling.

Main Results:

  • Weak left lateralization was observed for the visual-naming task (LI = 0.14, p = 0.038).
  • No significant language lateralization was found for the verb-generation task (LI = 0.08, p = 0.269).
  • Left hemisphere errors were more probable during visual naming, but not verb generation.

Conclusions:

  • Navigated rTMS may identify bilateral or weakly left-lateralized language sites in pediatric patients.
  • While rTMS is a valuable noninvasive tool for identifying potential language sites, it should not be used as the sole method for preoperative language mapping in children.