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

Preoperative navigated transcranial magnetic brain stimulation for tumors of the motor cortex

Meeting Abstract

  • S.M. Krieg - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München
  • E. Shiban - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München
  • N. Buchmann - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München
  • J. Sabih - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München
  • B. Meyer - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München
  • F. Ringel - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München

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.11.03

doi: 10.3205/12dgnc101, urn:nbn:de:0183-12dgnc1014

Published: June 4, 2012

© 2012 Krieg 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

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Objective: Navigated brain stimulation is a newly evolving technique independent from the it's accuracy compared to more commonly used modalities like direct cortical stimulation (DCS) and functional MRI (fMRI).

Methods: We examined 50 patients with tumors in or close to the precentral gyrus as well as in the subcortical white matter motor tract using navigated brain stimulation (NBS) with the Nexstim eXimia system. Data were sent to the neuronavigation system and correlated with intraoperative direct cortical stimulation.

Results: For lesions of the precentral gyrus, preoperative motor cortex mapping correlated well with intraoperative DCS with a deviation of 4.4 ± 3.4 mm. Comparing NBS with fMRI however; deviation was quite larger with 9.6 ± 7.9 mm for upper and 14.7 ± 12.4 mm for lower extremities. In patients with subcortical lesions DTI fiber tracking was performed using NBS mapping as seed region, which resulted in a subjectively more specific presentation of the corticospinal tract and less interobserver variability compared to conventional fiber tracking.

Conclusions: NBS correlates well with DCS as gold standard and, therefore, serves as a very valuable tool for non-invasive presurgical mapping of cortical motor presentation which can serve as seed region for DTI fiber tracking.