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73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

29.05. - 01.06.2022, Köln

Cortical representation of median and ulnar nerve suggests functional reorganisation induced by motor-eloquent gliomas

Die kortikal Repräsentation des N. medianus und N. ulnaris zeigt Hinweise für eine durch motorisch-eloquente Gliome induzierte funktionelle Reorganisation

Meeting Abstract

  • presenting/speaker Sebastian Ille - Klinikum rechts der Isar der TU München, Klinik und Poliklinik für Neurochirurgie, München, Deutschland
  • Haosu Zhang - Klinikum rechts der Isar der TU München, Klinik und Poliklinik für Neurochirurgie, München, Deutschland
  • Wei Zhang - Klinikum rechts der Isar der TU München, Klinik und Poliklinik für Neurochirurgie, München, Deutschland
  • Bernhard Meyer - Klinikum rechts der Isar der TU München, Klinik und Poliklinik für Neurochirurgie, München, Deutschland
  • Sandro M. Krieg - Klinikum rechts der Isar der TU München, Klinik und Poliklinik für Neurochirurgie, München, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie. Köln, 29.05.-01.06.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. DocV248

doi: 10.3205/22dgnc240, urn:nbn:de:0183-22dgnc2406

Published: May 25, 2022

© 2022 Ille et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objective: Navigated transcranial magnetic stimulation (nTMS) has been applied in routine clinical practice to localize motor-eloquent regions. Yet, the cortical representation of peripheral nerves nor their alterations by gliomas were investigated so far. The current study therefore analyzes the impact and impairment of the median and ulnar nerve in patients with supratentorial tumors by nTMS motor mapping.

Methods: Patients with motor-eloquent gliomas within the left hemisphere were grouped according to the presence of motor deficits. Peripheral nerves-based hand mapping regions were analyzed in grouped patients with (n=20) and without (n=24) motor deficits. Cortical motor representations were analyzed, and corresponding motor evoked potentials (MEP) and their center of gravity (CoG) were calculated for intergroup comparison.

Results: Patient characteristics including gender (p=0.679), tumor type (p=0.158) and age (p=0.97) did not differ between groups. Total motor mapping regions (p = 0.043, 6.47±3.62 cm2 vs. 4.69±1.92 cm2) and ulnar nerve-related mapping regions (p = 0.026, 4.03±3.27 cm2 vs. 2.33±1.46 cm2) were both significantly extended in patients with motor deficits. Still, median nerve-related mapping regions were larger in patients with motor deficits showing borderline significance (p=0.057, 5.79±3.41 cm2 vs. 4.16±2.10 cm2). There were no significant differences in the CoG of the median and ulnar nerve.

Conclusion: The present study shows similar intergroup CoG localizations, indicating the stability of hand motor function's critical regions. The extended cortical representation of median and ulnar nerve in patients with motor deficits suggests a potential mechanism of compensation and functional reorganization induced by motor-eloquent gliomas.