NTMS mapping of non-primary motor areas in brain tumour patients and healthy volunteers

Mirbagheri, Andia; Schneider, Heike; Zdunczyk, Anna; Vajkoczy, Peter; Picht, Thomas

doi:10.1007/s00701-019-04086-x

Cited by 10 publications

(6 citation statements)

References 47 publications

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“…average Pre time point peak-topeak amplitudes were on <15 µV) (figure 4). Despite reports that most MEPs over the non-motor cortical area do not result in responses greater than the minimum 50 µV amplitude [30,44,45], we expected that our BCI-FES interventions would facilitate corticospinal excitability after the intervention because the PFC and M1 areas are both involved in movement control [12,14,15]. However, our current study could not confirm this hypothesis.…”

Section: Effectiveness Of Motor Cortical Activity For Bci-fes-induced...contrasting

confidence: 66%

Effectiveness of motor and prefrontal cortical areas for brain-controlled functional electrical stimulation neuromodulation

Fadli,

Yamanouchi,

Jovanovic

et al. 2023

J. Neural Eng.

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Objective: Brain-computer interface (BCI)-controlled functional electrical stimulation (FES) could excite the central nervous system to enhance upper limb motor recovery. Our current study assessed the effectiveness of motor and prefrontal cortical activity-based BCI-FES to help elucidate the underlying neuromodulation mechanisms of this neurorehabilitation approach.Approach: The primary motor cortex (M1) and prefrontal cortex (PFC) BCI-FES interventions were performed for 25 min on separate days with twelve non-disabled participants. During the interventions, a single electrode from the contralateral M1 or PFC was used to detect event-related desynchronization (ERD) in the calibrated frequency range. If the BCI system detected ERD within 15 s of motor imagery, FES activated wrist extensor muscles. Otherwise, if the BCI system did not detect ERD within 15 s, a subsequent trial was initiated without FES. To evaluate neuromodulation effects, corticospinal excitability was assessed using single-pulse transcranial magnetic stimulation, and cortical excitability was assessed by motor imagery ERD and resting-state functional connectivity before, immediately, 30 min, and 60 min after each intervention.Main results: M1 and PFC BCI-FES interventions had similar success rates of approximately 80%, while the M1 intervention was faster in detecting ERD activity. Consequently, only the M1 intervention effectively elicited corticospinal excitability changes for at least 60 min around the targeted cortical area in the M1, suggesting a degree of spatial localization. However, cortical excitability measures did not indicate changes after either M1 or PFC BCI-FES.Significance: Neural mechanisms underlying the effectiveness of BCI-FES neuromodulation may be attributed to the M1 direct corticospinal projections and/or the closer timing between ERD detection and FES, which likely enhanced Hebbian-like plasticity by synchronizing cortical activation detected by the BCI system with the sensory nerve activation and movement related reafference elicited by FES.

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Section: Effectiveness Of Motor Cortical Activity For Bci-fes-induced...contrasting

confidence: 66%

Effectiveness of motor and prefrontal cortical areas for brain-controlled functional electrical stimulation neuromodulation

Fadli,

Yamanouchi,

Jovanovic

et al. 2023

J. Neural Eng.

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“…Finally, we aimed to distinguish effects of SMA and M1 stimulation to ensure recorded stimulation effects are not due to an indirect activation of the primary motor cortex [22]. In support of our protocol, errors induced during stimulation of the SMA hotspot were stronger than during M1 stimulation with the residual SMA targeting electric field.…”

Section: Discussionmentioning

confidence: 92%

Protocol for mapping of the supplementary motor area using repetitive navigated transcranial magnetic stimulation

Engelhardt

Kern

Karhu

et al. 2023

Preprint

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Background: Damage to the supplementary motor area (SMA) for example during surgery can lead to impairments of motor and language function. A detailed preoperative mapping of functional boarders of the SMA could therefore aid preoperative diagnostics in these patients. Objective: The aim of this study was the development of a repetitive nTMS protocol for non-invasive functional mapping of the SMA while assuring effects are indeed caused by SMA stimulation rather than activation of M1. Methods: To this purpose the SMA in the dominant hemisphere of twelve healthy subjects (28.2 +- 7.7 years, 6 females) was mapped using repetitive nTMS at 20 Hz (120% RMT), while subjects performed a finger tapping task. The location of induced errors was marked in each subjects individual MRI. To further validate the protocol, effects of SMA stimulation were directly compared to effects of M1 stimulation in four different tasks. Results: Mapping of the SMA was possible for all subjects, yet varying effect sizes were observed. Stimulation of the SMA led to a significant reduction of finger taps compared to baseline (BL: 45 taps, SMA: 35.5 taps; p < 0.01). Line tracing, writing and targeting of circles was less accurate during SMA compared to M1 stimulation. Conclusion: Mapping of the SMA using repetitive nTMS is feasible. While errors induced in the SMA are not entirely independent of M1 due to the proximity of both regions, disruption of the SMA induces functionally distinct errors. These error maps can aid preoperative diagnostics in patients with SMA related lesions.

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“… No adverse events Sollman N et al, 2016 39 X 110–130% X RMT The electric-field nTMS elicited more positive stimulus and positive/total stimulus rate compared to linear-TMS. No adverse events Bulubas L et al, 2016 41 Figure-of-eight stimulation coil 110–130% X RMT/latency/amplitude The nTMS showed that the motor areas were not restricted to the precentral gyrus, but that they spread in an anteroposterior fashion. Also, the distribution of primary motor areas and polysynaptic areas change dramatically depending on the localization of the tumor.…”

Section: Resultsmentioning

confidence: 98%

“…Moreover, a study showed that the nTMS could detect signals from non-primary motor-related areas (NPMA); however, in its majority, the MEP signals seemed to be derived from M1 areas. 41 Also, a study found that mapping the precentral gyrus of patients with tumors in that region elicited more MEPs counts (a count is an area that elicited signal after MEP stimulation) in this region than patients with a lesion in other regions. A similar response was seen in patients with postcentral gyrus (PoG) tumors with those patients presenting a higher number of MEPs counts in the PoG region compared to other patients.…”

Section: Resultsmentioning

confidence: 99%

Assessing the Capabilities of Transcranial Magnetic Stimulation (TMS) to Aid in the Removal of Brain Tumors Affecting the Motor Cortex: A Systematic Review

Schiavao¹,

Neville²,

Hayashi³

et al. 2022

NDT

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Introduction The brain tumor is frequently related to severe motor impairment and impacts the quality of life. The corticospinal tract can sometimes be affected depending on the type and size of the neoplasm, so different tools can evaluate motor function and connections. It is essential to organize surgical procedures and plan the approach. Functional motor status is mapped before, during, and after surgery. Studying corticospinal tract status can help map the functional areas, predict postoperative outcomes, and help the decision, reducing neurological deficits, aiming to preserve functional networks, using the concepts of white matters localization and fibbers connections. Nowadays, there are new techniques that provide functional information regarding the motor cortex, such as transcranial magnetic stimulation (TMS), direct cortical stimulation (DCS), and navigated TMS (nTMS). These tools can be used to plan a customized surgical strategy and the role of motor evoked potentials (MEPs) is well described during intra-operative, using intraoperative neuromonitoring. MEPs can help to localize primary motor areas and delineate the cut-off point of resection in real-time, using direct stimulation. In the post-operative, the MEP has increased your function as a predictive marker of permanent or transitory neurological lesion marker. Methods Systematic review performed in MEDLINE via PUBMED, EMBASE, and SCOPUS databases regarding the post-operative assessment of MEP in patients with brain tumors. The search strategy included the following terms: ((“Evoked Potentials, Motor”[Mesh]) AND “Neoplasms”[Mesh]) AND “Transcranial Magnetic Stimulation”[Mesh] AND “Brain Tumor”[Mesh]), the analysis followed the PRISMA guidelines for systematic reviews, the review spanned until 06/04/2021, inclusion criteria were studies presenting confirmed diagnosis of brain tumor (primary or metastatic), patients >18 y/o, using TMS, Navigated TMS, and/or Evoked Potentials as tools in preoperative planning or at the intra-operative helping the evaluation of the neurological status of the motor cortex, articles published in peer-reviewed journals, and written in English or Portuguese. Results A total of 38 studies were selected for this review, of which 14 investigated the potential of nTMS to predict the occurrence of motor deficits, while 25 of the articles investigated the capabilities of the nTMS technique in performing pre/intraoperative neuro mapping of the motor cortex. Conclusion Further studies regarding motor function assessment are needed and standardized protocols for MEPs also need to be defined.

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NTMS mapping of non-primary motor areas in brain tumour patients and healthy volunteers

Cited by 10 publications

References 47 publications

Effectiveness of motor and prefrontal cortical areas for brain-controlled functional electrical stimulation neuromodulation

Effectiveness of motor and prefrontal cortical areas for brain-controlled functional electrical stimulation neuromodulation

Protocol for mapping of the supplementary motor area using repetitive navigated transcranial magnetic stimulation

Assessing the Capabilities of Transcranial Magnetic Stimulation (TMS) to Aid in the Removal of Brain Tumors Affecting the Motor Cortex: A Systematic Review

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