Artikel
Preoperative detection of speech relevant cortical areas using navigated rTMS – a prospective study of 57 patients
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Veröffentlicht: | 4. Juni 2012 |
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Gliederung
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Objective: Aphasic disorders are common in brain tumours, e.g. which are localized in the left frontal and temporal lobe. In surgery maximal tumour reduction should be achieved while avoiding new aphasic deficit. We detect speech-relevant cortical areas preoperatively using navigated repetitive transcranial magnetic stimulation.
Methods: Patients underwent brain mapping by using highfrequent repetitive transcranial magnetic stimulation to induce speech arrest. Localization of speech-relevant cortical areas has been matched with the operative navigation software and has beeen considered in surgical intervention.
Results: 57 patients (average age 47 years) were considered, histology was glioma (n = 46), metastasis (n = 5), meningioma (n = 2) and others (n = 4). Tumour localization was in frontal or temporal lobe, left or right side. In 43 patients at least one speech relevant cortical area could be detected. 18 patients suffered from aphasic disorders preoperatively. We observed transient worsening in 8 patients, persisting in 2 cases until demission from hospital, but disappeared within 4 weeks. We did not observe any new persistent aphasic disorder.
Conclusions: Preoperative detection of speech relevant cortical areas using transcranial magnetic stimulation is a safe and reliable tool. Data can be used for planning surgical intervention, e.g. extent of resection. Preoperative brain mapping could be therefore a valuable alternative to awake surgery.