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Stereotactic transcranial magnetic stimulation: correlation with direct electrical cortical stimulation
T Krings1, B R Buchbinder, W E Butler
1Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Neurosurgery
|December 24, 1997
Summary
Stereotactic transcranial magnetic stimulation (TMS) accurately maps motor cortex function noninvasively. This technique shows promise for presurgical planning in neurosurgery.
Area of Science:
- Neurosurgery
- Neuroscience
- Medical Imaging
Background:
- Accurate presurgical mapping of the human motor cortex is crucial for optimizing surgical outcomes.
- Conventional methods like direct electrical cortical stimulation require invasive procedures under anesthesia.
- Noninvasive techniques are needed to complement or replace existing mapping methods.
Observation:
- Stereotactic transcranial magnetic stimulation (TMS) was applied to two patients with tumors near the central sulcus.
- TMS motor function maps were generated using 3D MRI data.
- These maps were compared with intraoperative direct electrical cortical stimulation results.
Findings:
- Stereotactic TMS was well-tolerated and consistent with known motor cortex somatotopy.
- A strong correlation was observed between TMS and electrical stimulation maps.
- Over 75% of TMS-evoked motor responses were localized within 1 cm of electrical stimulation sites.
Implications:
- Stereotactic TMS is a feasible and accurate noninvasive method for localizing cortical motor function.
- This technique holds potential as a valuable tool for presurgical planning.
- Noninvasive functional mapping can improve surgical precision and patient safety.