Abstract:
BACKGROUND:Tractography based on diffusion tensor imaging has become a popular tool for delineating white matter tracts for neurosurgical procedures. OBJECTIVE:To explore whether navigated transcranial magnetic stimulation (nTMS) might increase the accuracy of fiber tracking. METHODS:Tractography was performed according to both anatomic delineation of the motor cortex (n = 14) and nTMS results (n = 9). After implantation of the definitive electrode, stimulation via the electrode was performed, defining a stimulation threshold for eliciting motor evoked potentials recorded during deep brain stimulation surgery. Others have shown that of arm and leg muscles. This threshold was correlated with the shortest distance between the active electrode contact and both fiber tracks. Results were evaluated by correlation to motor evoked potential monitoring during deep brain stimulation, a surgical procedure causing hardly any brain shift. RESULTS:Distances to fiber tracks clearly correlated with motor evoked potential thresholds. Tracks based on nTMS had a higher predictive value than tracks based on anatomic motor cortex definition (P < .001 and P = .005, respectively). However, target site, hemisphere, and active electrode contact did not influence this correlation. CONCLUSION:The implementation of tractography based on nTMS increases the accuracy of fiber tracking. Moreover, this combination of methods has the potential to become a supplemental tool for guiding electrode implantation.
journal_name
Neurosurgeryjournal_title
Neurosurgeryauthors
Forster MT,Hoecker AC,Kang JS,Quick J,Seifert V,Hattingen E,Hilker R,Weise LMdoi
10.1227/NEU.0000000000000715subject
Has Abstractpub_date
2015-06-01 00:00:00pages
766-75; discussion 775-6issue
6eissn
0148-396Xissn
1524-4040pii
00006123-201506000-00025journal_volume
76pub_type
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