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Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Preoperative Cortical Mapping for Brain Tumor Surgery Using Navigated Transcranial Stimulation: Analysis of Accuracy

Version 1 : Received: 18 June 2024 / Approved: 19 June 2024 / Online: 19 June 2024 (05:53:30 CEST)

A peer-reviewed article of this Preprint also exists.

Paiva, W.S.; Fonoff, E.T.; dos Santos Silva, R.P.; Schiavao, L.; Brunoni, A.R.; de Almeida, C.C.; Júnior, C.C. Preoperative Cortical Mapping for Brain Tumor Surgery Using Navigated Transcranial Stimulation: Analysis of Accuracy. Brain Sci. 2024, 14, 867. Paiva, W.S.; Fonoff, E.T.; dos Santos Silva, R.P.; Schiavao, L.; Brunoni, A.R.; de Almeida, C.C.; Júnior, C.C. Preoperative Cortical Mapping for Brain Tumor Surgery Using Navigated Transcranial Stimulation: Analysis of Accuracy. Brain Sci. 2024, 14, 867.

Abstract

Transcranial magnetic stimulation (TMS) represents a distinctive technique for non-invasive brain stimulation. Recent advancements in image processing have enabled the enhancement of TMS by integrating magnetic resonance imaging (MRI) modalities with TMS via a neuronavigation system. The aim of this study is to assess the efficacy of navigated TMS for cortical mapping in comparison to surgical mapping using direct electrical stimulation (DES). The study involved 30 neurosurgical procedures for tumors located in or adjacent to the precentral gyrus. The DES points were compared with TMS responses based on the original distances of vectorial modules. There was a notable similarity in the points obtained from the two mapping methods. The distances between the geometric centers of TMS and DCS were 4.85 ± 1.89 mm. A strong correlation was identified between these vectorial points (r = 0.901, p < 0.001). The motor threshold in TMS was highest in the motor cortex adjacent to the tumor compared to the normal cortex (p < 0.001). Patients with deficits exhibited excellent accuracy in both methods. In view of this, TMS demonstrated reliable and precise application in brain mapping, which is a promising method for preoperative functional mapping in motor cortex tumor surgery.

Keywords

brain neoplasms; motor cortex; transcranial magnetic stimulation

Subject

Medicine and Pharmacology, Neuroscience and Neurology

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