TY - JOUR
T1 - Resection of meningiomas located in motor eloquent areas - comparative analysis of navigated transcranial magnetic stimulation and conventional neuronavigation
AU - Eibl, Thomas
AU - Schrey, Michael
AU - Rossmann, Jakob
AU - Liebert, Adrian
AU - Ritter, Leonard
AU - Lange, Ruediger
AU - Steiner, Hans-Herbert
AU - Schebesch, Karl-Michael
N1 - alle außer Lange: Department of Neurosurgery, Paracelsus Medical University, Nuremberg, Bavaria, Germany; Lange: Department of Neurology, Paracelsus Medical University, Nuremberg, Bavaria, Germany
PY - 2024/10/2
Y1 - 2024/10/2
N2 - BackgroundNavigated transcranial magnetic stimulation (nTMS) has been established as a preoperative diagnostic procedure in glioma surgery, increasing the extent of resection and preserving functional outcome. nTMS motor mapping for the resection of motor eloquent meningiomas has not been evaluated in a comparative analysis, yet.MethodsWe conducted a retrospective matched-pair analysis for tumor location and size in meningioma patients with tumors located over or close to the primary motor cortex. Half of the study population received nTMS motor mapping preoperatively (nTMS-group). The primary endpoint were permanent surgery-related motor deficits. Additional factors associated with new motor deficits were evaluated apart from nTMS.Results62 patients (mean age 62 +/- 15.8 years) were evaluated. 31 patients received preoperative nTMS motor mapping. In this group, motor thresholds (rMT) corresponded with tumor location and preoperative motor status, but could not predict motor outcome. No patient with preoperative intact motor function had a surgery-related permanent deficit in the nTMS group whereas four patients in the non-TMS group with preoperative intact motor status harbored from permanent deficits. 13 patients (21.3%) had a permanent motor deficit postoperatively with no difference between the nTMS and the non-TMS-group. Worsening in motor function was associated with higher patient age (p = 0.01) and contact to the superior sagittal sinus (p = 0.027).ConclusionnTMSmotor mapping did not lead to postoperative preservation in motorfunction. nTMS data corresponded well with the preoperative motorstatus and were associated with postoperative permanent deficits if tumors were located over the motor hotspot according to nTMS.
AB - BackgroundNavigated transcranial magnetic stimulation (nTMS) has been established as a preoperative diagnostic procedure in glioma surgery, increasing the extent of resection and preserving functional outcome. nTMS motor mapping for the resection of motor eloquent meningiomas has not been evaluated in a comparative analysis, yet.MethodsWe conducted a retrospective matched-pair analysis for tumor location and size in meningioma patients with tumors located over or close to the primary motor cortex. Half of the study population received nTMS motor mapping preoperatively (nTMS-group). The primary endpoint were permanent surgery-related motor deficits. Additional factors associated with new motor deficits were evaluated apart from nTMS.Results62 patients (mean age 62 +/- 15.8 years) were evaluated. 31 patients received preoperative nTMS motor mapping. In this group, motor thresholds (rMT) corresponded with tumor location and preoperative motor status, but could not predict motor outcome. No patient with preoperative intact motor function had a surgery-related permanent deficit in the nTMS group whereas four patients in the non-TMS group with preoperative intact motor status harbored from permanent deficits. 13 patients (21.3%) had a permanent motor deficit postoperatively with no difference between the nTMS and the non-TMS-group. Worsening in motor function was associated with higher patient age (p = 0.01) and contact to the superior sagittal sinus (p = 0.027).ConclusionnTMSmotor mapping did not lead to postoperative preservation in motorfunction. nTMS data corresponded well with the preoperative motorstatus and were associated with postoperative permanent deficits if tumors were located over the motor hotspot according to nTMS.
KW - Navigated transcranial magnetic stimulation
KW - Functional imaging
KW - Meningioma
KW - Neuronavigation- neurooncology
KW - Ntms motor mapping
UR - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=pmu_pure&SrcAuth=WosAPI&KeyUT=WOS:001260179400001&DestLinkType=FullRecord&DestApp=WOS_CPL
U2 - 10.1080/01616412.2024.2370731
DO - 10.1080/01616412.2024.2370731
M3 - Original Article
C2 - 38953309
SN - 0161-6412
VL - 46
SP - 965
EP - 971
JO - NEUROLOGICAL RESEARCH
JF - NEUROLOGICAL RESEARCH
IS - 10
ER -