Postoperative navigated transcranial magnetic stimulation to predict motor recovery after surgery of tumors in motor eloquent areas.

Seidel, Kathleen; Häni, Levin; Lutz, Katharina Sarah Jennifer; Zbinden, Chantal; Redmann, Annetta; Consuegra Lobato, Alberto; Raabe, Andreas; Schucht, Philippe (2019). Postoperative navigated transcranial magnetic stimulation to predict motor recovery after surgery of tumors in motor eloquent areas. Clinical neurophysiology, 130(6), pp. 952-959. Elsevier 10.1016/j.clinph.2019.03.015

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OBJECTIVE To know whether motor deficits after tumor surgery are transient is reassuring for the patient and crucial for planning rehabilitation and adjuvant treatment. We analyze the value of postoperative MRI navigated transcranial magnetic stimulation (nTMS) compared to intraoperative MEP monitoring in predicting recovery of motor function. METHODS Retrospective series of nTMS mappings within 14 days after surgery for supratentorial tumors (09/2014-05/2018). All patients with motor deficits of Medical-Research-Council-Grade (MRCS) 0-4- were included. RESULTS We performed nTMS mapping on average 3.8 days after surgery and recorded nTMS MEP in 11 of 13 patients. Motor strength recovered to at least MRCS 4 within one month if postoperative nTMS elicited MEPs (positive predictive value 90.9%). If nTMS did not elicit MEPs, the patient did not recover (negative predictive value 100%). Intraoperative MEP and postoperative nTMS were equally predictive for long-term motor recovery. In cases of intraoperative MEP alteration/signal loss, but a positive postoperative nTMS mapping, 2/3 patients demonstrated a good motor recovery. CONCLUSION nTMS may predict long-term motor recovery of patients suffering from severe motor deficits directly after resection of tumors located in motor eloquent areas. SIGNIFICANCE In cases of intraoperative MEP alterations, postoperative nTMS may clarify the potential for motor recovery.

Item Type:

Journal Article (Original Article)

Division/Institute:

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

UniBE Contributor:

Seidel, Kathleen; Häni, Levin; Lutz, Katharina Sarah Jennifer; Redmann, Annetta; Consuegra Lobato, Alberto; Raabe, Andreas and Schucht, Philippe

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1388-2457

Publisher:

Elsevier

Language:

English

Submitter:

Nicole Söll

Date Deposited:

26 Aug 2019 16:33

Last Modified:

23 Oct 2019 07:20

Publisher DOI:

10.1016/j.clinph.2019.03.015

PubMed ID:

30981901

Uncontrolled Keywords:

Brain mapping Brain tumor surgery Intraoperative neurophysiological monitoring Motor evoked potential Transcranial magnetic stimulation

BORIS DOI:

10.7892/boris.132393

URI:

https://boris.unibe.ch/id/eprint/132393

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