Navigated transcranial magnetic stimulation for preoperative language mapping in a patient with a left frontoopercular glioblastoma.

Up to now, navigated transcranial magnetic stimulation (nTMS) has been used for motor mapping in the vicinity of rolandic brain lesions. Recently, nTMS has also been suggested to be useful in mapping human language areas. The authors describe the case of a left-handed patient with a left-side glioblastoma within the opercular inferior frontal gyrus who presented with severe motor aphasia. Preoperative functional MRI (fMRI) indicated speech dominance of the right hemisphere and did not show any language-related activation in the vicinity of the tumor. Navigated TMS, however, showed a significantly higher rate of induced speech arrests for the left than for the right. Left-side direct cortical stimulation induced clear speech arrests during awake surgery. This case suggests that nTMS may be useful for preoperative speech mapping in tumors affecting the anatomy, vasculature, and brain oxygen levels and therefore impairing fMRI reliability.

[1]  J W Belliveau,et al.  Location of language in the cortex: a comparison between functional MR imaging and electrocortical stimulation. , 1997, AJNR. American journal of neuroradiology.

[2]  R J Ilmoniemi,et al.  Transcranial magnetic stimulation--a new tool for functional imaging of the brain. , 1999, Critical reviews in biomedical engineering.

[3]  Andreas Raabe,et al.  Functional Magnetic Resonance Imaging-integrated Neuronavigation: Correlation between Lesion-to-Motor Cortex Distance and Outcome , 2004, Neurosurgery.

[4]  Mitchel S Berger,et al.  Functional outcome after language mapping for glioma resection. , 2008, The New England journal of medicine.

[5]  Mitchel S Berger,et al.  Mapping the horizon: techniques to optimize tumor resection before and during surgery. , 2008, Clinical neurosurgery.

[6]  Á. Pascual-Leone,et al.  Repetitive transcranial magnetic stimulation of the dominant hemisphere can disrupt visual naming in temporal lobe epilepsy patientsfn2 fn2 Presented in part at the Annual Meeting of the American Neurological Association, October, 1996, Miami, FL. , 1999, Neuropsychologia.

[7]  Peter Vajkoczy,et al.  NAVIGATED TRANSCRANIAL MAGNETIC STIMULATION FOR PREOPERATIVE FUNCTIONAL DIAGNOSTICS IN BRAIN TUMOR SURGERY , 2009, Neurosurgery.

[8]  Costanza Papagno,et al.  Is Preoperative Functional Magnetic Resonance Imaging Reliable for Language Areas Mapping in Brain Tumor Surgery? Review of Language Functional Magnetic Resonance Imaging and Direct Cortical Stimulation Correlation Studies , 2010, Neurosurgery.

[9]  Harry A. Whitaker,et al.  Language localization and variability , 1978, Brain and Language.

[10]  Á. Pascual-Leone,et al.  Induction of speech arrest and counting errors with rapid‐rate transcranial magnetic stimulation , 1991, Neurology.

[11]  Wade M Mueller,et al.  Lesion-induced Pseudo-dominance at Functional Magnetic Resonance Imaging: Implications for Preoperative Assessments , 2004, Neurosurgery.

[12]  Dietmar Frey,et al.  Preoperative Functional Mapping for Rolandic Brain Tumor Surgery: Comparison of Navigated Transcranial Magnetic Stimulation to Direct Cortical Stimulation , 2011, Neurosurgery.

[13]  Elke Hattingen,et al.  Navigated Transcranial Magnetic Stimulation and functional Magnetic Resonance Imaging – advanced adjuncts in preoperative planning for central region tumors , 2010 .

[14]  James F. Brinkley,et al.  Analysis of naming errors during cortical stimulation mapping: Implications for models of language representation , 2010, Brain and Language.

[15]  Wade M Mueller,et al.  Pseudo-reorganization of language cortical function at fMR imaging: a consequence of tumor-induced neurovascular uncoupling. , 2003, AJNR. American journal of neuroradiology.

[16]  G. Ojemann,et al.  Cortical language localization in left, dominant hemisphere. An electrical stimulation mapping investigation in 117 patients. , 1989, Journal of neurosurgery.

[17]  K. Meador,et al.  Optimum stimulus parameters for lateralized suppression of speech with magnetic brain stimulation , 1996, Neurology.

[18]  J. Karhu,et al.  Navigated transcranial magnetic stimulation , 2010, Neurophysiologie Clinique/Clinical Neurophysiology.

[19]  C M Epstein,et al.  Transcranial magnetic stimulation: language function. , 1998, Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society.

[20]  Armin Thron,et al.  Introducing navigated transcranial magnetic stimulation as a refined brain mapping methodology , 2001, Neurosurgical Review.

[21]  K. Boulanouar,et al.  Language Functional Magnetic Resonance Imaging in Preoperative Assessment of Language Areas: Correlation with Direct Cortical Stimulation , 2003, Neurosurgery.

[22]  Jeffrey G. Ojemann,et al.  Increased Functional Vascular Response in the Region of a Glioma , 1998, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[23]  S. Petersen,et al.  Human Brain Mapping 6:203–215(1998) � Functional MRI Studies of Word-Stem Completion: Reliability Across Laboratories and Comparison to Blood Flow Imaging With PET , 2022 .

[24]  W F Taylor,et al.  Neurosurgical management of low-grade astrocytoma of the cerebral hemispheres. , 1984, Journal of neurosurgery.

[25]  J. Mäkelä,et al.  A novel approach for documenting naming errors induced by navigated transcranial magnetic stimulation , 2012, Journal of Neuroscience Methods.

[26]  F. Bellivier,et al.  The value of navigation-guided rTMS for the treatment of depression: An illustrative case , 2007, Neurophysiologie Clinique/Clinical Neurophysiology.

[27]  David Brauge,et al.  Awake Craniotomy vs Surgery Under General Anesthesia for Resection of Supratentorial Lesions , 2011, Neurosurgery.

[28]  Giuseppe Scotti,et al.  Motor and language DTI Fiber Tracking combined with intraoperative subcortical mapping for surgical removal of gliomas , 2008, NeuroImage.

[29]  B. Meyer,et al.  Predictive value and safety of intraoperative neurophysiological monitoring with motor evoked potentials in glioma surgery. , 2012, Neurosurgery.

[30]  B R Rosen,et al.  Stereotactic transcranial magnetic stimulation: correlation with direct electrical cortical stimulation. , 1997, Neurosurgery.

[31]  R J Ilmoniemi,et al.  Modeling of the stimulating field generation in TMS. , 1999, Electroencephalography and clinical neurophysiology. Supplement.

[32]  R. Cox,et al.  Functional MR activation correlated with intraoperative cortical mapping. , 1997, AJNR. American journal of neuroradiology.

[33]  Harold Goodglass,et al.  Picture-naming in aphasia , 1985, Brain and Language.

[34]  B. Meyer,et al.  Utility of presurgical navigated transcranial magnetic brain stimulation for the resection of tumors in eloquent motor areas. , 2012, Journal of neurosurgery.

[35]  R. Töpper,et al.  Repetitive Transcranial Magnetic Stimulation Effects on Language Function Depend on the Stimulation Parameters , 2001, Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society.