ROLE OF NTMS BRAIN MAPPING IN PRESERVING FUNCTIONAL INTEGRITY OF MOTOR AND LANGUAGE AREAS AND PREVENTING POSTOPERATIVE DEFICITS IN PATIENTS WITH MALIGNANT BRAIN TUMORS

Abstract

Introduction Navigated transcranial magnetic stimulation (nTMS) is a non-invasive preoperative mapping technique used to identify eloquent cortical areas. Malignant brain tumors often have an infiltrative growth pattern, making complete resection difficult, especially when these tumors are situated in eloquent regions. In this paper, we present our experience with nTMS cortical mapping for malignant brain tumors located in eloquent areas. Material and Methods Patients with malignant brain tumors located in motor or language eloquent areas who underwent nTMS mapping followed by surgery at our institution were included in the study. Patients were excluded if they presented TMS or MRI contraindications. Results Patients with gliomas and metastases located in motor or language eloquent areas were included in the study. The results of the nTMS brain mapping were integrated into the intraoperative neuronavigation system and used to guide surgical planning. nTMS was useful in determining the eloquent areas, especially for motor cortex. No patients suffered new-onset or worsening of the preexistent neurological deficits following surgery. Conclusions nTMS preoperative cortical mapping combined with intraoperative neuronavigation is a valuable tool for the resection of malignant brain tumors. It offers guidance for avoiding eloquent areas, thereby improving the functional outcomes for patients.

Keywords

• navigated transcranial magnetic stimulation
• brain mapping
• malignant brain tumours