Functional Plasticity of the Motor Cortical Structures Demonstrated by Navigated TMS in Two Patients with Epilepsy

Mäkelä, Jyrki P.; Vitikainen, Anne-Mari; Lioumis, Pantelis; Paetau, Ritva; Ahtola, Eero; Kuusela, Linda; Valanne, Leena; Blomstedt, Göran; Gaily, Eija

doi:10.1016/j.brs.2012.04.012

Cited by 43 publications

(19 citation statements)

References 28 publications

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“…Accurately mapping between two different brains (e.g., template and patient) is still an unsolved problem due to the lack of one‐to‐one correspondence between cortical folds of two individuals . Furthermore, the functional anatomy of epilepsy patients may be shifted due to reorganization secondary to pathologic plasticity in epileptogenic networks . This is the main limitation of any parcellation algorithm applied to epileptic brain; therefore, all clinical information gained from these images should only be used in conjunction with results of cortical stimulation or other electrophysiologic‐based mapping .…”

Section: Discussionmentioning

confidence: 99%

An open‐source automated platform for three‐dimensional visualization of subdural electrodes using CT‐MRI coregistration

Azarion

Pearce

et al. 2014

Epilepsia

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Objective Visualizing implanted subdural electrodes in 3D space can greatly aid planning, executing, and validating resection in epilepsy surgery. Coregistration software is available, but cost, complexity, insufficient accuracy or validation limit adoption. We present a fully automated open-source application, based upon a novel method using post-implant CT and post-implant MR images, for accurately visualizing intracranial electrodes in 3D space. Methods CT-MR rigid brain coregistration, MR non-rigid registration, and prior-based segmentation were carried out on 7 subjects. Post-implant CT, post-implant MR, and an external labeled atlas were then aligned in the same space. The coregistration algorithm was validated by manually marking identical anatomical landmarks on the post-implant CT and post-implant MR images. Following coregistration, distances between the center of the landmark masks on the post-implant MR and the coregistered CT images were calculated for all subjects. Algorithms were implemented in open-source software and translated into a “drag and drop” desktop application for Apple Mac OS X. Results Despite post-operative brain deformation, the method was able to automatically align intra-subject multi-modal images and segment cortical subregions so that all electrodes could be visualized on the parcellated brain. Manual marking of anatomical landmarks validated the coregistration algorithm with a mean misalignment distance of 2.87 ± 0.58 mm between the landmarks. Software was easily used by operators without prior image processing experience. Significance We demonstrate an easy to use, novel platform for accurately visualizing subdural electrodes in 3D space on a parcellated brain. We rigorously validated this method using quantitative measures. The method is unique because it involves no pre-processing, is fully automated, and freely available worldwide. A desktop application, as well as the source code, are both available for download on the International Epilepsy Electrophysiology Portal (https://www.ieeg.org/) for use and interactive refinement.

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Section: Discussionmentioning

confidence: 99%

An open‐source automated platform for three‐dimensional visualization of subdural electrodes using CT‐MRI coregistration

Azarion

Pearce

et al. 2014

Epilepsia

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“…This method has also been applied to analyze the networks responsible for higher cerebral functions such as attention (Leitao et al, 2015), working memory (Lorenc et al, 2015), perception (Pitcher et al, 2014), learning (Steel et al, 2016), and decision making (Rahnev et al, 2016). Furthermore, recently, the application of these methods has been expanded to some patients with neurological and psychological disorders such as Parkinson’s disease (Cerasa et al, 2015), stroke (Cunningham et al, 2015), epilepsy (Makela et al, 2013), pain (Martin et al, 2013), addiction (Hanlon et al, 2015), brain injury (Guller et al, 2014), peripheral nerve injury (Li et al, 2015), depression (Li et al, 2004), and schizophrenia (Gromann et al, 2012, Guller et al, 2012). …”

Section: Tms-fmrimentioning

confidence: 99%

Contribution of transcranial magnetic stimulation to assessment of brain connectivity and networks

Hallett

Iorio

Rossini

et al. 2017

Clinical Neurophysiology

133

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The goal of this review is to show how transcranial magnetic stimulation (TMS) techniques can make a contribution to the study of brain networks. Brain networks are fundamental in understanding how the brain operates. Effects on remote areas can be directly observed or identified after a period of stimulation, and each section of this review will discuss one method. EEG analyzed following TMS is called TMS-evoked potentials (TEPs). A conditioning TMS can influence the effect of a test TMS given over the motor cortex. A disynaptic connection can be tested also by assessing the effect of a pre-conditioning stimulus on the conditioning-test pair. Basal ganglia-cortical relationships can be assessed using electrodes placed in the process of deep brain stimulation therapy. Cerebellar-cortical relationships can be determined using TMS over the cerebellum. Remote effects of TMS on the brain can be found as well using neuroimaging, including both positron emission tomography (PET) and functional magnetic resonance imaging (fMRI). The methods complement each other since they give different views of brain networks, and it is often valuable to use more than one technique to achieve converging evidence. The final product of this type of work is to show how information is processed and transmitted in the brain.

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“…Navigated TMS may show the development of post-stroke neuronal plasticity with shifting of the primary representation areas. This advances our prognostic evaluation and offers insights for innovative therapeutic strategies [11].…”

Section: Therapeutic Use Of Navigated Tmsmentioning

confidence: 95%

Navigated Brain Stimulation (NBS) for Pre-Surgical Planning of Brain Lesion in Critical Areas: Basic Principles and Early Experience

Alafaci¹,

Conti²,

Tomasello³

2013

Clinical Management and Evolving Novel Therapeutic Strategies for Patients With Brain Tumors

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Functional Plasticity of the Motor Cortical Structures Demonstrated by Navigated TMS in Two Patients with Epilepsy

Cited by 43 publications

References 28 publications

An open‐source automated platform for three‐dimensional visualization of subdural electrodes using CT‐MRI coregistration

An open‐source automated platform for three‐dimensional visualization of subdural electrodes using CT‐MRI coregistration

Contribution of transcranial magnetic stimulation to assessment of brain connectivity and networks

Navigated Brain Stimulation (NBS) for Pre-Surgical Planning of Brain Lesion in Critical Areas: Basic Principles and Early Experience

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