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.

Keywords

functional magnetic resonance imaging tumor brain transcranial magnetic stimulation surface anatomy scanning

Get full access to this article

View all access options for this article.

References

Krings

Buchbinder

: Functional magnetic resonance imaging and transcranial magnetic stimulation: Complimentary approaches in the evaluation of cortical motor function. Neurology 48: 1406–1416, 1997.

Righini

de Divitiis

: Functional MRI: Primary motor cortex localization in patients with brain tumors. J Comput Assist Tomogr 20: 702–708, 1996.

Jack

Jr Thompson

: Sensory motor cortex: Correlation of presurgical mapping with functional MR imaging and invasive cortical mapping. Radiology 190: 85–92, 1994.

Yoshiura

Hasuo

: Increased activity of the ipsilateral motor cortex during a hand motor task in patients with brain tumor and paresis. Am J Neuroradiol 18: 865–869, 1997.

Morioka

Yamamoto

: Comparison of magnetoen-cephalography, functional MRI, and motor evoked potentials in the localization of the sensory-motor cortex. Neurol Res 17: 361–367, 1995.

Brasil-Neto

McShane

: Topographic mapping of the human cortex with magnetic stimulation: Factor affecting accuracy and reproducibility. Electoroencephalogr Clin Neurophysiol 85: 9–16, 1992.