Artikel
Cortical plasticity of language function in glioma patients as measured by nrTMS
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Veröffentlicht: | 18. Juni 2018 |
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Gliederung
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Objective: Cortical plasticity has been shown in glioma patients by direct cortical stimulation (DCS) during awake craniotomy. However, this invasive option for repeated mapping is only available in case of tumor recurrence and after decision for a second surgery. Navigated repetitive transcranial magnetic stimulation (nrTMS) has shown a high correlation to the results of DCS during awake craniotomy for language-negative regions. The present study aims to examine the cortical plasticity of language-negative regions in glioma patients.
Methods: We included 14 patients with left-sided perisylvian gliomas who underwent preoperative nrTMS language mapping twice. The mean time between mappings was 17 ± 12 months. Cortex was separated into anterior (A) and posterior (P) language-eloquent regions. In order to perform analysis we defined a tumor area (T) and an area without tumor (WOT) based on the subdivision into A and P regions.
Results: We detected changes of cortical language function in all patients. In 8 of 14 patients (57.1%) we found more language-negative regions within the T area during the second nrTMS mapping (26 vs. 11 during first mapping). Three patients (21.4%) showed no change of language-negative cortical regions. In three patients (21.4%) nrTMS detected less language-negative regions within the T area during the second mapping (22 vs. 34 during the first mapping).
Conclusion: Present results show that nrTMS might be able to show cortical plasticity of language-negative regions in glioma patients. However, the reliability of our results has to be confirmed in a larger cohort and by DCS during awake craniotomy.