Presurgical Mapping with Functional MR Imaging versus Transcranial Magnetic Stimulation Combined with Surface Anatomy Scanning

Abstract

Fifteen patients, who had tumors in or near the precentral gyrus, underwent functional magnetic resonance imaging (fMRI) and transcranial magnetic stimulation (TMS) combined with surface anatomy scanning (SAS) for presurgical mapping of the sensory motor cortex. TMS activated the motor cortex in all patients and fMRI demonstrated task activation of sensory motor cortex in 14 of the 15 patients. The marker of TMS superimposed on SAS and fMRI activation agreed within 0.5 cm in 11 of the 14 patients. In the remaining three, the distance of these mapped sites ranged from 1 cm to 1.5 cm, and SAS showed a deformity of the central sulcus which may cause the deviation of activated site with TMS. The cortical surface projection of TMS using SAS and fMRI has good spatial relationship and is useful in identifying a primary motor cortex in presurgical planning.