gms | German Medical Science

65th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

11 - 14 May 2014, Dresden

Cortical language mapping by navigated transcranial magnetic stimulation combined with fMRI and DTI connectivity analysis

Meeting Abstract

  • Georg Neuloh - Klinik für Neurochirurgie, Universitätsklinikum der RWTH Aachen
  • Mikhail Zvyagintsev - Insitut für Interdisziplinäre Forschung, Universitätsklinikum der RWTH Aachen
  • Gianluca Mingoia - Insitut für Interdisziplinäre Forschung, Universitätsklinikum der RWTH Aachen
  • Hans Clusmann - Klinik für Neurochirurgie, Universitätsklinikum der RWTH Aachen
  • Katrin Sakreida - Klinik für Neurochirurgie, Universitätsklinikum der RWTH Aachen

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocMI.19.06

doi: 10.3205/14dgnc392, urn:nbn:de:0183-14dgnc3924

Published: May 13, 2014

© 2014 Neuloh et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: Navigated transcranial magnetic stimulation (nTMS) can idientify cortical areas involved in language processing in analogy to electrical cortex stimulation in awake brain surgery and may contribute to the understanding of the language processing networks in the brain. In this study we combined nTMS language mapping results with functional and structural magnet resonance imaging (MRI) connectivity analyses.

Method: Non-motor speech arrest was induced by nTMS in a naming paradigm, at individually adapted magnetic field intensity levels, in the left inferior frontal gyrus of 20 healthy subjects. Diffusion tensor MRI and functional MRI (fMRI), both at rest and during a naming task similar to the language paradigm during nTMS, were recorded at the 3T TIM Trio Siemens scanner. Cortical sites with nTMS-induced speech arrest (nTMS-positive) and sites without speech arrest (nTMS-negative) were seeds in resting state functional connectivity analyses and in probabilistic DTI tractography.

Results: In the preliminary analysis of a subset of data, nTMS-positive sites were located closer to the areas of enhanced BOLD signal in task-dependent fMRI than nTMS-negative sites. Seeds-based resting state connectivity analysis revealed a typical language-related fronto-parieto-temporal network for nTMS-positive sites, whereas no such connectivity was detected using the nTMS-negative seeds. DTI tractography starting from nTMS-positive sites yielded fronto-parieto-temporal connections corresponding to the arcuate fasciculus.

Conclusions: Results of nTMS language mapping in the inferior frontal gyrus are consistent with fMRI results from a language processing paradigm and lead to the detection of conventional language-related functional-structural networks of the brain.