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Updated: May 28, 2026
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A Standardized Protocol for Functional Motor Mapping Using Navigated Transcranial Magnetic Stimulation
Published on: February 27, 2026
Navigated Transcranial Magnetic Stimulation (nTMS): From Functional Brain Mapping to Clinical Applications in
Marcin Karol Setlak1, Bartłomiej Błaszczyk1, Maciej Wojtacha1
1Department of Neurosurgery, University Clinical Center, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland.
Biomedicines
|May 27, 2026
Summary
Navigated transcranial magnetic stimulation (nTMS) offers advanced, noninvasive brain mapping for neurosurgery, particularly for motor cortex identification. While promising for motor mapping, language mapping and other applications require further standardization and research.
Area of Science:
- Neurosurgery and Neuroscience
- Medical Imaging and Brain Mapping
Background:
- Navigated transcranial magnetic stimulation (nTMS) is a sophisticated, noninvasive technique for functional brain mapping.
- Its primary neurosurgical value is identifying eloquent cortical areas and integrating functional data into surgical planning.
Purpose of the Study:
- To review the historical, technical, and clinical applications of TMS/nTMS in neurosurgery.
- To evaluate the evidence for nTMS in motor and language mapping, diagnostics, and therapy.
- To identify limitations and future directions for nTMS implementation in patient care.
Main Methods:
- A narrative review incorporating a structured literature search.
- Focus on neurosurgical applications, including comparisons with fMRI and direct cortical stimulation.
- Discussion of safety, limitations, and broader neurological uses.
Main Results:
- Strongest evidence supports nTMS for preoperative motor mapping in patients with tumors near the motor cortex.
- Language mapping, diagnostics, and therapeutic repetitive TMS (rTMS) applications show more heterogeneous results.
- Interpretation of these applications requires careful consideration of evidence, protocols, and patient selection.
Conclusions:
- nTMS is a valuable tool for preoperative motor mapping in neurosurgery.
- Further multicenter studies and standardized protocols are needed to optimize its role in personalized neurological care.
- Integration with advanced imaging and tractography will enhance its utility.
