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Review

Mapping of Motor Function with Neuronavigated Transcranial Magnetic Stimulation: A Review on Clinical Application in Brain Tumors and Methods for Ensuring Feasible Accuracy

1
Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany
2
Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
3
TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, 81675 Munich, Germany
4
Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, San Francisco, CA 94143, USA
5
Department of Neurosurgery, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
6
Department of Clinical Neurophysiology, Kuopio University Hospital, 70029 Kuopio, Finland
7
Department of Applied Physics, University of Eastern Finland, 70211 Kuopio, Finland
*
Author to whom correspondence should be addressed.
Academic Editor: Lorenzo Rocchi
Brain Sci. 2021, 11(7), 897; https://doi.org/10.3390/brainsci11070897
Received: 4 June 2021 / Revised: 29 June 2021 / Accepted: 2 July 2021 / Published: 7 July 2021
Navigated transcranial magnetic stimulation (nTMS) has developed into a reliable non-invasive clinical and scientific tool over the past decade. Specifically, it has undergone several validating clinical trials that demonstrated high agreement with intraoperative direct electrical stimulation (DES), which paved the way for increasing application for the purpose of motor mapping in patients harboring motor-eloquent intracranial neoplasms. Based on this clinical use case of the technique, in this article we review the evidence for the feasibility of motor mapping and derived models (risk stratification and prediction, nTMS-based fiber tracking, improvement of clinical outcome, and assessment of functional plasticity), and provide collected sets of evidence for the applicability of quantitative mapping with nTMS. In addition, we provide evidence-based demonstrations on factors that ensure methodological feasibility and accuracy of the motor mapping procedure. We demonstrate that selection of the stimulation intensity (SI) for nTMS and spatial density of stimuli are crucial factors for applying motor mapping accurately, while also demonstrating the effect on the motor maps. We conclude that while the application of nTMS motor mapping has been impressively spread over the past decade, there are still variations in the applied protocols and parameters, which could be optimized for the purpose of reliable quantitative mapping. View Full-Text
Keywords: brain stimulation; brain tumor; electric field; eloquent cortex; functional mapping; motor mapping; motor threshold; navigated transcranial magnetic stimulation; neuronavigation; presurgical evaluation brain stimulation; brain tumor; electric field; eloquent cortex; functional mapping; motor mapping; motor threshold; navigated transcranial magnetic stimulation; neuronavigation; presurgical evaluation
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MDPI and ACS Style

Sollmann, N.; Krieg, S.M.; Säisänen, L.; Julkunen, P. Mapping of Motor Function with Neuronavigated Transcranial Magnetic Stimulation: A Review on Clinical Application in Brain Tumors and Methods for Ensuring Feasible Accuracy. Brain Sci. 2021, 11, 897. https://doi.org/10.3390/brainsci11070897

AMA Style

Sollmann N, Krieg SM, Säisänen L, Julkunen P. Mapping of Motor Function with Neuronavigated Transcranial Magnetic Stimulation: A Review on Clinical Application in Brain Tumors and Methods for Ensuring Feasible Accuracy. Brain Sciences. 2021; 11(7):897. https://doi.org/10.3390/brainsci11070897

Chicago/Turabian Style

Sollmann, Nico, Sandro M. Krieg, Laura Säisänen, and Petro Julkunen. 2021. "Mapping of Motor Function with Neuronavigated Transcranial Magnetic Stimulation: A Review on Clinical Application in Brain Tumors and Methods for Ensuring Feasible Accuracy" Brain Sciences 11, no. 7: 897. https://doi.org/10.3390/brainsci11070897

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