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A Standardized Protocol for Functional Motor Mapping Using Navigated Transcranial Magnetic Stimulation.

Benjamin Bardel1, Jean-Pascal Lefaucheur2, Thibaut Mussigmann3

  • 1UR 4391, ENT Team, Faculty of Health, Paris Est Créteil University; Department of Clinical Neurophysiology, DMU FIxIT, Henri Mondor University Hospital, APHP; Department of Clinical Neurophysiology, Aarhus University Hospital; benjamin.bardel@aphp.fr.

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Summary
This summary is machine-generated.

Navigated transcranial magnetic stimulation (nTMS) precisely maps motor cortex and corticospinal tract using brain imaging. This method aids in presurgical planning to preserve motor function and study neuroplasticity.

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Area of Science:

  • Neuroscience
  • Neurosurgery
  • Medical Imaging

Background:

  • Navigated transcranial magnetic stimulation (nTMS) integrates individual brain imaging for precise coil positioning, enhancing anatomical targeting.
  • Neuronavigation systems are crucial for optimizing coil positioning in repetitive TMS (rTMS) and functional brain mapping.
  • nTMS is vital for identifying eloquent motor and language areas before tumor resection and monitoring neurological diseases.

Purpose of the Study:

  • To present a standardized protocol for motor mapping using nTMS combined with diffusion tensor imaging (DTI)-based corticospinal tract (CST) reconstruction.
  • To enable precise delineation of eloquent motor cortical regions and subcortical projections.
  • To detect functional reorganization in patients with brain lesions and guide presurgical planning.

Main Methods:

  • Utilized nTMS for cortical stimulation and functional mapping.
  • Integrated DTI-based CST reconstruction for visualizing subcortical white matter tracts.
  • Developed a standardized protocol for reproducible clinical application.

Main Results:

  • Achieved precise delineation of eloquent motor cortical regions and their subcortical projections.
  • Enabled detection of functional reorganization in patients with adjacent lesions.
  • Provided guidance for individualized surgical strategies to maximize resection while preserving motor function.

Conclusions:

  • The presented nTMS and DTI protocol is reproducible, clinically applicable, and suitable for routine workflows.
  • This integrated approach offers a promising tool for neuroplasticity research and rehabilitation planning.
  • It enhances presurgical planning for maximizing lesion resection and preserving motor function.