Related Experiment Video
Updated: Mar 13, 2026
Localizing Function-specific Targets for Transcranial Magnetic Stimulation in the Absence of Navigation Equipment
Published on: May 23, 2025
Functional gradient analysis reveals potential therapeutic mechanisms of nrTMS for postoperative motor deficits in
Yuzhe Li1, Jiangwei Wang2, Zhong Zhang3
1Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Research Unit of Accurate Diagnosis, Treatment, and Translational Medicine of Brain Tumors, Chinese Academy of Medical Sciences, Beijing, China.
Objective:
This study aimed to investigate the therapeutic effects and neural mechanisms of high-frequency neuro-navigated repetitive transcranial magnetic stimulation (nrTMS) targeting the hand knob in glioma patients with postoperative motor deficits, using functional gradient analysis to characterize cortical reorganization.
Methods:
Thirty patients with postoperative motor deficits were randomized to receive nrTMS or sham stimulation targeting the ipsilateral hand knob. Motor function was assessed using Fugl-Meyer Assessment (FMA) and muscle strength. Resting-state fMRI was acquired to compute principal functional gradients. Control/tumor, nrTMS/sham, and Pre-TMS/Post-TMS gradient changes were analyzed. Correlation and regression analyses related to motor recovery were performed.
Results:
The nrTMS group showed significantly greater improvement in muscle strength (Post-treatment: nrTMS: 3.533 ± 0.720, Sham: 2.067 ± 0.572, p = 0.019, d = 1.082; 3-month follow-up: nrTMS: 4.600 ± 0.408, Sham: 3.733 ± 0.609, p = 0.035, d = 1.012). Gradient analysis revealed increased sensorimotor network (SMN) gradient scores following nrTMS (Pre-TMS: -0.707 ± 0.108; Post-TMS: -0.636 ± 0.077; p = 0.016), and HH_SomMot_22 within upper limb motor cortex is most strongly correlated with motor recovery.
Conclusions:
High-frequency nrTMS targeting the hand knob accelerated the motor recovery. Gradient analysis findings provide novel insights into therapeutic mechanisms of nrTMS and underscore the value of the hand knob as a stimulation target.
