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Evaluating postoperative motor function using postoperative navigated transcranial magnetic stimulation motor

Thomas Eibl1, Adrian Liebert1, Leonard Ritter1

  • 1Department of Neurosurgery, Paracelsus Medical University, Breslauer Str. 201, 90471, Nuremberg, Bavaria, Germany.

Neurophysiologie Clinique = Clinical Neurophysiology
|April 16, 2025
PubMed
Summary
This summary is machine-generated.

Postoperative navigated transcranial magnetic stimulation (nTMS) motor mapping may predict functional recovery in brain tumor patients with transient motor deficits. Eliciting motor evoked potentials (MEPs) with nTMS post-surgery indicated significant motor improvement.

Keywords:
Brain tumor surgeryDiffusion tensor imagingMotor functionNavigated transcranial magnetic stimulationNeuro-oncology

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Area of Science:

  • Neurosurgery
  • Neurophysiology
  • Medical Imaging

Background:

  • Navigated transcranial magnetic stimulation (nTMS) is used for preoperative motor mapping in brain tumor surgery.
  • Postoperative nTMS for evaluating corticospinal tract (CST) injuries and functional outcomes is less explored.

Purpose of the Study:

  • To evaluate the utility of postoperative nTMS motor mapping in predicting functional recovery after brain tumor resection.
  • To assess surgery-associated CST injuries and functional outcomes using nTMS.

Main Methods:

  • Retrospective evaluation of patients undergoing brain tumor resection with pre- and postoperative nTMS.
  • Inclusion criteria: postoperative motor deficit or no significant improvement of preoperative deficit (MRC ≤3/5).
  • CST visualization via diffusion tensor imaging (DTI); primary outcome: MRC ≥4/5 motor status at 3 months.

Main Results:

  • 17 patients included; 82.4% had recordable motor evoked potentials (MEPs).
  • Positive predictive value (PPV) for motor recovery was 90.5%; negative predictive value (NPV) was 38.5%.
  • Increased motor thresholds in the operated hemisphere post-surgery (p=0.008); stable in contralateral hemisphere (p=0.11).

Conclusions:

  • Postoperative nTMS motor mapping shows potential in predicting functional recovery of transient motor deficits.
  • Significant motor improvement was observed when MEPs could be elicited postoperatively.
  • Further studies are needed to confirm the predictive value of nTMS for functional recovery.