Protocol for motor and language mapping by navigated TMS in patients and healthy volunteers; workshop report.

Krieg, Sandro M; Lioumis, Pantelis; Mäkelä, Jyrki P; Wilenius, Juha; Karhu, Jari; Hannula, Henri; Savolainen, Petri; Lucas, Carolin Weiss; Seidel, Kathleen; Laakso, Aki; Islam, Mominul; Vaalto, Selja; Lehtinen, Henri; Vitikainen, Anne-Mari; Tarapore, Phiroz E; Picht, Thomas (2017). Protocol for motor and language mapping by navigated TMS in patients and healthy volunteers; workshop report. Acta neurochirurgica, 159(7), pp. 1187-1195. Springer 10.1007/s00701-017-3187-z

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INTRODUCTION Navigated transcranial magnetic stimulation (nTMS) is increasingly used for preoperative mapping of motor function, and clinical evidence for its benefit for brain tumor patients is accumulating. In respect to language mapping with repetitive nTMS, literature reports have yielded variable results, and it is currently not routinely performed for presurgical language localization. The aim of this project is to define a common protocol for nTMS motor and language mapping to standardize its neurosurgical application and increase its clinical value. METHODS The nTMS workshop group, consisting of highly experienced nTMS users with experience of more than 1500 preoperative nTMS examinations, met in Helsinki in January 2016 for thorough discussions of current evidence and personal experiences with the goal to recommend a standardized protocol for neurosurgical applications. RESULTS nTMS motor mapping is a reliable and clinically validated tool to identify functional areas belonging to both normal and lesioned primary motor cortex. In contrast, this is less clear for language-eloquent cortical areas identified by nTMS. The user group agreed on a core protocol, which enables comparison of results between centers and has an excellent safety profile. Recommendations for nTMS motor and language mapping protocols and their optimal clinical integration are presented here. CONCLUSION At present, the expert panel recommends nTMS motor mapping in routine neurosurgical practice, as it has a sufficient level of evidence supporting its reliability. The panel recommends that nTMS language mapping be used in the framework of clinical studies to continue refinement of its protocol and increase reliability.

Item Type:

Journal Article (Review Article)


04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurosurgery

UniBE Contributor:

Seidel, Kathleen


600 Technology > 610 Medicine & health








Nicole Söll

Date Deposited:

26 Feb 2018 08:35

Last Modified:

24 Oct 2019 18:56

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

Brain tumor Epilepsy surgery Language Motor Preoperative mapping Transcranial magnetic stimulation




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