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Minim Invasive Neurosurg 2001; 44(4): 234-239
DOI: 10.1055/s-2001-19935
Original Article
Georg Thieme Verlag Stuttgart · New York

Navigated Transcranial Magnetic Stimulation for Presurgical Planning

Correlation with Functional MRIT.  Krings1, 2 , H.  Foltys4 , M.  H. T.  Reinges2 , S.  Kemeny1, 4 , V.  Rohde1 , U.  Spetzger2 , J.  M.  Gilsbach2, 3 , A.  Thron1, 3
  • 1Department of Neuroradiology, University Hospital of the University of Technology, Aachen, Germany
  • 2Department of Neurosurgery, University Hospital of the University of Technology, Aachen, Germany
  • 3Interdisciplinary Center for Clinical Research - Central Nervous System, University Hospital of the University of Technology, Aachen, Germany
  • 4Department of Neurology, University Hospital of the University of Technology, Aachen, Germany
Further Information

Publication History

Publication Date:
01 February 2002 (online)

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Abstract

Purpose: This paper describes the potential of navigated transcranial magnetic stimulation to map the motor cortex in patients with mass lesions near the primary motor cortex by comparing the results of this technique to those of functional MRI. Material and Methods: Ten patients with mass lesions near the central sulcus were studied preoperatively using a figure-of-eight transcranial magnetic stimulator attached to a neuronavigation system to allow for direct visualization of the stimulated brain region. Subsequently, in all patients a blood oxygenation level dependent 2D multislice multishot T2*-weighted gradient echo EPI sequence on a 1.5 T Philips Gyroscan during motor activation was performed. Results of both methods were coregistered and compared. Results: The distances between the peak parenchymal fMRI activation and the cortical area where TMS elicited the maximum MEPs ranged between 0 and 1.2 cm (mean 0.6 cm, SD 0.4 cm). Conclusion: We conclude that navigated TMS is a reliable alternative for localizing the motor-related areas in the human brain preoperatively and therefore may be a useful adjunct or, in selected patients, even a helpful alternative to functional MRI.

Key words

Functional Magnetic Resonance Imaging - Motor Cortex - Presurgical Planning - Transcranial Magnetic Stimulation

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T. Krings, M.D. 

Department of Neuroradiology · Klinikum RWTH Aachen

Pauwelsstr. 30

52057 Aachen

Germany

Phone: +49-241-8089-602

Fax: +49-241-8888-440

Email: tkrings@izkf.rwth.aachen.de

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