gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

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Preoperative detection of speech relevant cortical areas using navigated rTMS – a prospective study of 57 patients

Meeting Abstract

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  • S. Frank - Klinik für Neurochirurgie, Klinikum der Friedrich-Schiller-Universität Jena
  • A. Waschke - Klinik für Neurochirurgie, Klinikum der Friedrich-Schiller-Universität Jena
  • J. Walter - Klinik für Neurochirurgie, Klinikum der Friedrich-Schiller-Universität Jena
  • C. Ewald - Klinik für Neurochirurgie, Klinikum der Friedrich-Schiller-Universität Jena
  • R. Kalff - Klinik für Neurochirurgie, Klinikum der Friedrich-Schiller-Universität Jena

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocDO.11.05

doi: 10.3205/12dgnc103, urn:nbn:de:0183-12dgnc1032

Published: June 4, 2012

© 2012 Frank et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective: Aphasic disorders are common in brain tumours, e.g. which are localized in the left frontal and temporal lobe. In surgery maximal tumour reduction should be achieved while avoiding new aphasic deficit. We detect speech-relevant cortical areas preoperatively using navigated repetitive transcranial magnetic stimulation.

Methods: Patients underwent brain mapping by using highfrequent repetitive transcranial magnetic stimulation to induce speech arrest. Localization of speech-relevant cortical areas has been matched with the operative navigation software and has beeen considered in surgical intervention.

Results: 57 patients (average age 47 years) were considered, histology was glioma (n = 46), metastasis (n = 5), meningioma (n = 2) and others (n = 4). Tumour localization was in frontal or temporal lobe, left or right side. In 43 patients at least one speech relevant cortical area could be detected. 18 patients suffered from aphasic disorders preoperatively. We observed transient worsening in 8 patients, persisting in 2 cases until demission from hospital, but disappeared within 4 weeks. We did not observe any new persistent aphasic disorder.

Conclusions: Preoperative detection of speech relevant cortical areas using transcranial magnetic stimulation is a safe and reliable tool. Data can be used for planning surgical intervention, e.g. extent of resection. Preoperative brain mapping could be therefore a valuable alternative to awake surgery.