nTMS has proven useful for preoperative workup of brain tumor and epilepsy surgery in localization of the motor cortical areas. A videoed nrTMS setup with object naming to localize language-related cortical areas in preoperative planning was developed in BioMag laboratory. The method has high sensitivity and predicts tolerably the cortical areas not involved in language in comparison with the results of DES during object naming in patients going through awake craniotomy. The optimal stimulus parameters to get the most precise preoperative information are still searched for. The method may also have potential for follow-up of plastic cortical changes due to tumor growth or after their removal. No harmful side effects have occurred in the control or patient studies. Although the reports using nrTMS language mapping combined with tractography to localize the language network as a rescue strategy for patients not amenable to DES are favorable, awake craniotomy is still the gold standard of functional localization of cortical language-related areas.

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nTMS Language Mapping: Basic Principles and Clinical Use

  • Jyrki P. Mäkelä,
  • Aki Laakso

摘要

nTMS has proven useful for preoperative workup of brain tumor and epilepsy surgery in localization of the motor cortical areas. A videoed nrTMS setup with object naming to localize language-related cortical areas in preoperative planning was developed in BioMag laboratory. The method has high sensitivity and predicts tolerably the cortical areas not involved in language in comparison with the results of DES during object naming in patients going through awake craniotomy. The optimal stimulus parameters to get the most precise preoperative information are still searched for. The method may also have potential for follow-up of plastic cortical changes due to tumor growth or after their removal. No harmful side effects have occurred in the control or patient studies. Although the reports using nrTMS language mapping combined with tractography to localize the language network as a rescue strategy for patients not amenable to DES are favorable, awake craniotomy is still the gold standard of functional localization of cortical language-related areas.