Evaluation of Changes in Preoperative Cortical Excitability by Navigated Transcranial Magnetic Stimulation in Patients With Brain Tumor
Background: This prospective study aimed to evaluate the cortical excitability (CE) of patients with brain tumors surrounding or directly involving the corticospinal tract (CST) using navigated transcranial magnetic stimulation (nTMS).Methods: We recruited 40 patients with a single brain tumor surro...
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Frontiers Media S.A.
2021-01-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2020.582262/full |
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| author | Iuri Santana Neville Iuri Santana Neville Iuri Santana Neville Alexandra Gomes dos Santos Cesar Cimonari Almeida Cesar Cimonari Almeida Cintya Yukie Hayashi Cintya Yukie Hayashi Davi Jorge Fontoura Solla Ricardo Galhardoni Ricardo Galhardoni Ricardo Galhardoni Daniel Ciampi de Andrade Daniel Ciampi de Andrade Daniel Ciampi de Andrade Andre Russowsky Brunoni Manoel Jacobsen Teixeira Wellingson Silva Paiva Wellingson Silva Paiva |
| author_facet | Iuri Santana Neville Iuri Santana Neville Iuri Santana Neville Alexandra Gomes dos Santos Cesar Cimonari Almeida Cesar Cimonari Almeida Cintya Yukie Hayashi Cintya Yukie Hayashi Davi Jorge Fontoura Solla Ricardo Galhardoni Ricardo Galhardoni Ricardo Galhardoni Daniel Ciampi de Andrade Daniel Ciampi de Andrade Daniel Ciampi de Andrade Andre Russowsky Brunoni Manoel Jacobsen Teixeira Wellingson Silva Paiva Wellingson Silva Paiva |
| author_sort | Iuri Santana Neville |
| collection | DOAJ |
| description | Background: This prospective study aimed to evaluate the cortical excitability (CE) of patients with brain tumors surrounding or directly involving the corticospinal tract (CST) using navigated transcranial magnetic stimulation (nTMS).Methods: We recruited 40 patients with a single brain tumor surrounding or directly involving the CST as well as 82 age- and sex-matched healthy controls. The patients underwent standard nTMS and CE evaluations. Single and paired pulses were applied to the primary motor area (M1) of both affected and unaffected cerebral hemispheres 1 week before surgery. The CE parameters included resting motor threshold (RMT), motor evoked potential (MEP) ratio for 140 and 120% stimulus (MEP 140/120 ratio), short-interval intracortical inhibition (SICI), and intracortical facilitation (ICF). Motor outcome was evaluated on hospital discharge and on 30-day and 90-day postoperative follow-up.Results: In the affected hemispheres of patients, SICI and ICF were significantly higher than in the unaffected hemispheres (p=0.002 and p=0.009, respectively). The 140/120 MEP ratio of patients' unaffected hemispheres was lower than that in controls (p=0.001). Patients with glioblastomas (GBM) had a higher interhemispheric RMT ratio than patients with grade II and III gliomas (p = 0.018). A weak correlation was observed among the RMT ratio and the preoperative motor score (R2 = 0.118, p = 0.017) and the 90-day follow-up (R2 = 0.227, p = 0.016).Conclusion: Using preoperative nTMS, we found that brain hemispheres affected by tumors had abnormal CE and that patients with GBM had a distinct pattern of CE. These findings suggest that tumor biological behavior might play a role in CE changes. |
| first_indexed | 2024-12-16T23:01:38Z |
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| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-16T23:01:38Z |
| publishDate | 2021-01-01 |
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| series | Frontiers in Neurology |
| spelling | doaj.art-fbae94b46146404cbc25fcc67e0ab5342022-12-21T22:12:43ZengFrontiers Media S.A.Frontiers in Neurology1664-22952021-01-011110.3389/fneur.2020.582262582262Evaluation of Changes in Preoperative Cortical Excitability by Navigated Transcranial Magnetic Stimulation in Patients With Brain TumorIuri Santana Neville0Iuri Santana Neville1Iuri Santana Neville2Alexandra Gomes dos Santos3Cesar Cimonari Almeida4Cesar Cimonari Almeida5Cintya Yukie Hayashi6Cintya Yukie Hayashi7Davi Jorge Fontoura Solla8Ricardo Galhardoni9Ricardo Galhardoni10Ricardo Galhardoni11Daniel Ciampi de Andrade12Daniel Ciampi de Andrade13Daniel Ciampi de Andrade14Andre Russowsky Brunoni15Manoel Jacobsen Teixeira16Wellingson Silva Paiva17Wellingson Silva Paiva18Instituto do Cancer do Estado de São Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, BrazilLIM-62/Division of Neurosurgery, Department of Neurology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, BrazilService of Interdisciplinary Neuromodulation, Instituto de Psiquiatria do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, BrazilLIM-62/Division of Neurosurgery, Department of Neurology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, BrazilLIM-62/Division of Neurosurgery, Department of Neurology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, BrazilService of Interdisciplinary Neuromodulation, Instituto de Psiquiatria do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, BrazilLIM-62/Division of Neurosurgery, Department of Neurology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, BrazilService of Interdisciplinary Neuromodulation, Instituto de Psiquiatria do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, BrazilLIM-62/Division of Neurosurgery, Department of Neurology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, BrazilLIM-62/Division of Neurosurgery, Department of Neurology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, BrazilService of Interdisciplinary Neuromodulation, Instituto de Psiquiatria do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, BrazilSchool of Medicine - Universidade da Cidade de São Paulo UNICID, São Paulo, BrazilInstituto do Cancer do Estado de São Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, BrazilLIM-62/Division of Neurosurgery, Department of Neurology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, BrazilService of Interdisciplinary Neuromodulation, Instituto de Psiquiatria do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, BrazilService of Interdisciplinary Neuromodulation, Instituto de Psiquiatria do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, BrazilLIM-62/Division of Neurosurgery, Department of Neurology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, BrazilLIM-62/Division of Neurosurgery, Department of Neurology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, BrazilService of Interdisciplinary Neuromodulation, Instituto de Psiquiatria do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, BrazilBackground: This prospective study aimed to evaluate the cortical excitability (CE) of patients with brain tumors surrounding or directly involving the corticospinal tract (CST) using navigated transcranial magnetic stimulation (nTMS).Methods: We recruited 40 patients with a single brain tumor surrounding or directly involving the CST as well as 82 age- and sex-matched healthy controls. The patients underwent standard nTMS and CE evaluations. Single and paired pulses were applied to the primary motor area (M1) of both affected and unaffected cerebral hemispheres 1 week before surgery. The CE parameters included resting motor threshold (RMT), motor evoked potential (MEP) ratio for 140 and 120% stimulus (MEP 140/120 ratio), short-interval intracortical inhibition (SICI), and intracortical facilitation (ICF). Motor outcome was evaluated on hospital discharge and on 30-day and 90-day postoperative follow-up.Results: In the affected hemispheres of patients, SICI and ICF were significantly higher than in the unaffected hemispheres (p=0.002 and p=0.009, respectively). The 140/120 MEP ratio of patients' unaffected hemispheres was lower than that in controls (p=0.001). Patients with glioblastomas (GBM) had a higher interhemispheric RMT ratio than patients with grade II and III gliomas (p = 0.018). A weak correlation was observed among the RMT ratio and the preoperative motor score (R2 = 0.118, p = 0.017) and the 90-day follow-up (R2 = 0.227, p = 0.016).Conclusion: Using preoperative nTMS, we found that brain hemispheres affected by tumors had abnormal CE and that patients with GBM had a distinct pattern of CE. These findings suggest that tumor biological behavior might play a role in CE changes.https://www.frontiersin.org/articles/10.3389/fneur.2020.582262/fullmotor outcomeglioblastomaneuromodulationbrain tumortranscranial magnetic stimulationcortical excitability |
| spellingShingle | Iuri Santana Neville Iuri Santana Neville Iuri Santana Neville Alexandra Gomes dos Santos Cesar Cimonari Almeida Cesar Cimonari Almeida Cintya Yukie Hayashi Cintya Yukie Hayashi Davi Jorge Fontoura Solla Ricardo Galhardoni Ricardo Galhardoni Ricardo Galhardoni Daniel Ciampi de Andrade Daniel Ciampi de Andrade Daniel Ciampi de Andrade Andre Russowsky Brunoni Manoel Jacobsen Teixeira Wellingson Silva Paiva Wellingson Silva Paiva Evaluation of Changes in Preoperative Cortical Excitability by Navigated Transcranial Magnetic Stimulation in Patients With Brain Tumor Frontiers in Neurology motor outcome glioblastoma neuromodulation brain tumor transcranial magnetic stimulation cortical excitability |
| title | Evaluation of Changes in Preoperative Cortical Excitability by Navigated Transcranial Magnetic Stimulation in Patients With Brain Tumor |
| title_full | Evaluation of Changes in Preoperative Cortical Excitability by Navigated Transcranial Magnetic Stimulation in Patients With Brain Tumor |
| title_fullStr | Evaluation of Changes in Preoperative Cortical Excitability by Navigated Transcranial Magnetic Stimulation in Patients With Brain Tumor |
| title_full_unstemmed | Evaluation of Changes in Preoperative Cortical Excitability by Navigated Transcranial Magnetic Stimulation in Patients With Brain Tumor |
| title_short | Evaluation of Changes in Preoperative Cortical Excitability by Navigated Transcranial Magnetic Stimulation in Patients With Brain Tumor |
| title_sort | evaluation of changes in preoperative cortical excitability by navigated transcranial magnetic stimulation in patients with brain tumor |
| topic | motor outcome glioblastoma neuromodulation brain tumor transcranial magnetic stimulation cortical excitability |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2020.582262/full |
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