Home > Riviste > Journal of Neurosurgical Sciences > Fascicoli precedenti > Journal of Neurosurgical Sciences 2019 April;63(2) > Journal of Neurosurgical Sciences 2019 April;63(2):106-13

ULTIMO FASCICOLO
 

JOURNAL TOOLS

eTOC
Per abbonarsi
Sottometti un articolo
Segnala alla tua biblioteca
 

ARTICLE TOOLS

Publication history
Estratti
Permessi
Per citare questo articolo

 

ORIGINAL ARTICLE  CEREBRAL GLIOMA IN HIGHLY ELOQUENT AREAS: MANAGEMENT AND OUTCOME 

Journal of Neurosurgical Sciences 2019 April;63(2):106-13

DOI: 10.23736/S0390-5616.18.04591-5

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

Comparison of hemispheric dominance and correlation of evoked speech responses between functional magnetic resonance imaging and navigated transcranial magnetic stimulation in language mapping

Gregor DURNER , Andrej PALA, Lena FEDERLE, Brigitta GROLIK, Christian R. WIRTZ, Jan COBURGER

Department of Neurosurgery, Campus Günzburg, University of Ulm, Günzburg, Germany



BACKGROUND: Non-invasive language mapping is commonly facilitated via two different approaches, functional magnetic resonance imaging (fMRI) and navigated transcranial magnetic stimulation (nTMS). The aim of our examination was to compare both methods regarding hemispheric dominance and detection of involved cortex in speech-processing.
METHODS: Since 2015, patients with language eloquent tumors received both fMRI and nTMS language mapping in our facility. Hemispheric dominance for fMRI (word pairing task) and nTMS (picture naming) was defined according to activation/response predominance between hemispheres. For a detailed comparison of methods, we used a cortical parcellation system and correlated activations of each gyrus. Statistical analysis was performed using Sign test, Spearman’s rank correlation coefficient and Mann-Whitney-U test.
RESULTS: Twenty-three patients with predominantly frontal and temporal tumors were enrolled. fMRI and nTMS predicted the same hemispheric dominance in 67% of examinations. No significant difference was found between the tests (P=0.63). When examining the correlation of anatomical areas with speech relevance between the two methods, we found significant differences in activation patterns of language relevant areas when comparing patients inter-individually. Using 2/3 rule for evoked language errors in nTMS improved congruence in perisylvian regions.
CONCLUSIONS: fMRI and nTMS lead to comparable results in determining hemispheric dominance, however they show significantly different results in predicting language relevant areas. We recommend using 2/3 rule for nTMS to improve congruence. Both tools seem to be valuable methods for preoperative planning. However, surgical decision making concerning resectability of language eloquent lesions should be based on awake craniotomy, furthermore.


KEY WORDS: Transcranial magnetic stimulation - Magnetic resonance imaging - Dominance, cerebral

inizio pagina