title: Preoperative functional mapping for rolandic brain tumor surgery.
abstract: The resection of tumors within or close to eloquent motor areas is usually guided by the compromise between the maximal allowed resection and preservation of neurological functions. Navigated transcranial magnetic stimulation (nTMS) is an emerging technology that can be used for preoperative mapping of the motor cortex. We performed pre-surgical mapping by using nTMS in 17 patients with lesions in or close to the precentral gyrus. The study was conducted on consecutive patients scheduled for surgical treatment. nTMS allowed to exactly localize the motor cortex in 88.2% of cases. In 70.6% it provided the surgeon with new unexpected information about functional anatomy of the motor area, influencing the pre-operative planning. Moreover, in 29.4% these functional information had a clear impact on surgery, making necessary a change of surgical strategy to avoid damage to the motor cortex. Our results prove that nTMS has a large benefit in the treatment of rolandic brain tumors. It adds important information about spatial relationship between functional motor cortex and the tumor and reduces surgical-related post-operative motor deficits.
authors.affiliation: Department of Neurosciences, University of Messina, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Rizzo
authors.affiliation: Department of Neurosciences, University of Messina, Italy.
authors.forename: Carmen
authors.initials: C
authors.lastname: Terranova
authors.affiliation: Department of Neurosciences, University of Messina, Italy.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Conti
authors.affiliation: Department of Neurosciences, University of Messina, Italy.
authors.forename: Antonino
authors.initials: A
authors.lastname: Germanò
authors.affiliation: Department of Neurosciences, University of Messina, Italy.
authors.forename: Concetta
authors.initials: C
authors.lastname: Alafaci
authors.affiliation: Department of Neurosciences, University of Messina, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Raffa
authors.affiliation: Department of Neurosciences, University of Messina, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Girlanda
authors.affiliation: Department of Neurosciences, University of Messina, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Tomasello
authors.affiliation: Department of Neurosciences, University of Messina, Italy; I.R.C.C.S "Centro Studi Neurolesi" Messina, Italy. Electronic address: angelo.quartarone@unime.it.
authors.forename: Angelo
authors.initials: A
authors.lastname: Quartarone
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D019635:Neurosurgical Procedures; D057234:Preoperative Period; D050781:Transcranial Magnetic Stimulation
keywords: Brain tumor; Connectivity; Functional mapping; Motor cortex; Navigated transcranial magnetic stimulation