ArticleFrontiers in oncology2021
Preoperative nTMS and Intraoperative Neurophysiology - A Comparative Analysis in Patients With Motor-Eloquent Glioma.
Article in Frontiers in oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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15 citing papers in PubMed, 25 citations in OpenAlex.
- Resting-State vs. Task-Based Functional Magnetic Resonance Imaging in Neurosurgical Planning: A Narrative Review of Clinical Applications.Biomedicines · 2026Review
- Postoperative ischemia and neurological deficits after glioma resection: A systematic review and meta-analysis.Neuro-oncology practice · 2026Review
- The Weight of Eloquence in Motor Area Glioblastoma: Oncologic Outcome After nTMS-Guided Surgical Resection.NeuroSci · 2025Article
- Role of patient frailty in resection of newly diagnosed motor eloquent glioblastomas guided by a navigated transcranial magnetic stimulation and tractography approach.Journal of neuro-oncology · 2025Article
- Intraoperative Cortical Sensorimotor Mapping During Glioma Resection Monitored With Drum Playing During Awake Craniotomy: A Case Report.Case reports in oncological medicine · 2025Article
- Transcranial Magnetic Stimulation-Electroencephalography (TMS-EEG) in Neurosurgery: Unexplored Path Towards Personalized Brain Surgery.Journal of personalized medicine · 2024Review
- Article
- Preoperative mapping techniques for brain tumor surgery: a systematic review.Frontiers in oncology · 2024Review
- Review
- Selective Stimulus Intensity during Hotspot Search Ensures Faster and More Accurate Preoperative Motor Mapping with nTMS.Brain sciences · 2023Article
- Comparison of anatomical-based vs. nTMS-based risk stratification model for predicting postoperative motor outcome and extent of resection in brain tumor surgery.NeuroImage. Clinical · 2023Article
- Assessing the feasibility of mapping the tibialis anterior muscle with navigated transcranial magnetic stimulation in neuro-oncologic patients.Scientific reports · 2022Article
- Current Status of Neuromodulation-Induced Cortical Prehabilitation and Considerations for Treatment Pathways in Lower-Grade Glioma Surgery.Life (Basel, Switzerland) · 2022Review
- MRI-Based Risk Assessment for Incomplete Resection of Brain Metastases.Frontiers in oncology · 2022Article
- Diffusion tensor imaging, intra-operative neurophysiological monitoring and small craniotomy: Results in a consecutive series of 103 gliomas.Frontiers in oncology · 2022Article
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe resection of a motor-eloquent glioma should be guided by intraoperative neurophysiological monitoring (IOM) but its interpretation is often difficult and may (unnecessarily) lead to subtotal resection. Navigated transcranial magnetic stimulation (nTMS) combined with diffusion-tensor-imaging (DTI) is able to stratify patients with motor-eloquent lesion preoperatively into high- and low-risk cases with respect to a new motor deficit.
objectiveTo analyze to what extent preoperative nTMS motor risk stratification can improve the interpretation of IOM phenomena.
methodsIn this monocentric observational study, nTMS motor mapping with DTI fiber tracking of the corticospinal tract was performed before IOM-guided surgery for motor-eloquent gliomas in a prospectively collected cohort from January 2017 to October 2020. Descriptive analyses were performed considering nTMS data (motor cortex infiltration, resting motor threshold (RMT), motor evoked potential (MEP) amplitude, latency) and IOM data (transcranial MEP monitoring, intensity of monopolar subcortical stimulation (SCS), somatosensory evoked potentials) to examine the association with the postoperative motor outcome (assessed at day of discharge and at 3 months).
resultsThirty-seven (56.1%) of 66 patients (27 female) with a median age of 48 years had tumors located in the right hemisphere, with glioblastoma being the most common diagnosis with 39 cases (59.1%). Three patients (4.9%) had a new motor deficit that recovered partially within 3 months and 6 patients had a persistent deterioration (9.8%). The more risk factors of the nTMS risk stratification model (motor cortex infiltration, tumor-tract distance (TTD) ≤8mm, RMT
conclusionsThe preoperative nTMS-based risk assessment can help to interpret ambiguous IOM phenomena (such as irreversible MEP amplitude decrease ≤50%) and adjustment of SCS stimulation intensity.
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