title: [Navigated transcranial magnetic stimulation for preoperative mapping of the eloquent cortex].
abstract: BACKGROUND
  Brain tumor surgery in functionally relevant areas is particularly challenging. Preoperative functional mapping with navigated transcranial magnetic stimulation (TMS) was introduced into the clinical routine in 2009 and since then has seen widespread adoption.
  
  
  OBJECTIVE
  Accuracy and consistency of TMS motor and language mapping and its clinical relevance.
  
  
  METHODS
  Analysis of published scientific papers and discussion of the findings.
  
  
  RESULTS
  Positive (i.e. motor responses are elicited) and negative cortical points for TMS motor mapping can be used for treatment planning and intraoperative decision making. Language mapping points (disruption of language function) positive in TMS can support treatment planning but should be confirmed intraoperatively with direct electrical stimulation. Negative TMS language mapping (language functions are not disrupted) correlates well with the gold standard of intraoperative testing. Recent studies reported improved treatment outcome after preoperative TMS mapping.
  
  
  CONCLUSIONS
  Patients suffering from brain tumors in eloquent locations should be counseled based on individual functional mapping data before surgery and TMS is a valid non-invasive methodology which can provide such functional mapping.
authors.affiliation: Neurochirurgische Klinik, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Deutschland. thomas.picht@charite.de.
authors.forename: T
authors.initials: T
authors.lastname: Picht
mesh_terms: D001931:Brain Mapping / Q000379:methods*; D001932:Brain Neoplasms / Q000175:diagnosis / Q000601:surgery*; D002540:Cerebral Cortex / Q000601:surgery*; D006801:Humans; D007802:Language; D038361:Neuronavigation / Q000379:methods*; D050781:Transcranial Magnetic Stimulation / Q000379:methods*
keywords: Brain mapping; Brain tumor; Language mapping; Navigated transcranial magnetic stimulation; Noninvasive mapping