Introducing navigated transcranial magnetic stimulation as a refined brain mapping methodology |
| |
Authors: | Timo Krings Keith H Chiappa Henrik Foltys Marcus H Reinges Rees G Cosgrove Armin Thron |
| |
Institution: | (1) University Hospital of the Technical University of Aachen, Interdisciplinary Center of Clinical Research – Central Nervous System, Aachen, Germany,;(2) Massachusetts General Hospital, Boston, Mass., USA,;(3) Department of Neurosurgery and Neuroradiology, University Hospital of the Technical University of Aachen, Pauwelsstrasse 30, 52057 Aachen, Germany, |
| |
Abstract: | A major intrinsic limitation of transcranial magnetic stimulation (TMS) to map the human brain lies in the unclear relationship
between the position of the stimulating coil on the scalp and the underlying stimulated cortex. The relationship between structure
and function as the major feature constituting a brain mapping modality can therefore not be established. Recent advances
in image processing allowed us to refine TMS by combining magnetic resonance imaging (MRI) modalities with TMS using a neuronavigation
system to measure the position of the stimulating coil and map this position onto a MRI data set. This technique has several
advantages over recent TMS mapping strategies. The position of the coil on the scalp can be held constant as verified by real
time visual guidance. When evaluating higher cortical functions, the relationship between underlying cortical anatomy and
the scalp stimulation site can be accurately assessed. Cortical motor output maps can be easily obtained for preoperative
planning and decision making for mass lesions near rolandic cortex in patients. In conclusion, navigated TMS is a reliable
alternative for localizing cortical functions and therefore may be a useful adjunct or in selected patients even a helpful
alternative to other functional neuroimaging methods.
Electronic Publication |
| |
Keywords: | Brain mapping Motor system Presurgical planning Neuronavigation Functional imaging |
本文献已被 SpringerLink 等数据库收录! |
|