Objective To verify the reliability of transcranial magnetic stimulation(TMS)in preoperative mapping relative to intraoperative direct electrical stimulation(DES).Methods Twenty language-eloquent glioma patients were enrolled.Ten of them underwent preoperative navigated TMS(nTMS)mapping(nTMS group),and the other ten were assigned to DES group.Before surgery,TMS was performed during a language task in the nTMS group.Sites in the cortex at which this task was disturbed in three consecutive trials were recorded and defined as nTMS hotspots(HSnTMS).Both groups then underwent awake surgery and intraoperative language mapping with DES.DES hotspots(HSDES)were also determined.The spatial distribution of HSnTMS and HSDES in the nTMS group was recorded and registered in a single brain template for comparison.The center of gravity(CoG)based on HSnTMS and diffusion tensor imaging fiber tracking of CoG based on HSDES were performed.The electromagnetic simulation was conducted,and then the values between nTMS group and DES group were compared.Results HSnTMS and HSDES showed similar distributions[mean distance:(6.32±2.60)mm,distance range:2.20-9.30 mm,95％CI:3.9-8.7].A higher fractional anisotropy value(P=0.037 3)and an analogous fiber bundle length(P=0.229 0)were observed in nTMS mapping.A similar distribution of the electric field in brain tissues induced by nTMS and DES was noted.Conclusion Preoperative TMS provides data equally crucial to DES and thus facilitates precise brain mapping.
关键词
经颅磁刺激/语言定位/纤维束追踪/电磁仿真/直接电刺激
Key words
transcranial magnetic stimulation/language mapping/fiber tracking/electromagnetic simulation/direct electrical stimulation
维普
万方数据