Department of Neurosurgery, Charité University Hospital, Augustenburger Platz 1, 13353, Berlin, Germany.
Acta Neurochir (Wien). 2013 Jul;155(7):1309-17. doi: 10.1007/s00701-013-1665-5. Epub 2013 Mar 12.
Navigated transcranial magnetic stimulation (nTMS) is increasingly being used for preoperative mapping of the motor cortex. Any new technology should undergo rigorous validation before being widely adopted in routine clinical practice. The aim of this experimental study was to assess the intraexaminer and interexaminer reliability of topographic mapping with nTMS.
nTMS mapping of the motor cortex for the first dorsal interosseous (FDI) muscle was performed by an expert and a novice examiner, twice in ten healthy volunteers and once in ten tumor patients. The distances between the centers-of-gravity and hotspots were calculated, as were coefficients of variation. This study also compared orthogonal versus variable orientation of the stimulation coil.
The mean (range) distance between centers-of-gravity for the expert examiner in the test-retest protocol with healthy volunteers was 4.40 (1.86-7.68) mm. The mean (range) distance between centers-of-gravity for the expert vs. novice examiner was 4.89 (2.39-9.22) mm. There were no significant differences in this result between healthy volunteers and tumor patients.
nTMS is sufficiently reliable for clinical use, but examiners should make efforts to minimize sources of error. The reliability of nTMS in tumor patients appears comparable to healthy subjects.
经颅导航磁刺激（nTMS）越来越多地用于运动皮层的术前定位。任何新技术在广泛应用于常规临床实践之前，都应经过严格的验证。本实验研究旨在评估 nTMS 对运动皮层的定位图的评估者内和评估者间可靠性。
由一名专家和一名新手评估员对 10 名健康志愿者和 10 名肿瘤患者的第一背侧骨间（FDI）肌进行 nTMS 映射。计算了重心和热点之间的距离以及变异系数。本研究还比较了刺激线圈的正交与可变方向。
在具有健康志愿者的测试-重测方案中，专家评估员的重心之间的平均（范围）距离为 4.40（1.86-7.68）mm。专家与新手评估员之间的重心之间的平均（范围）距离为 4.89（2.39-9.22）mm。在健康志愿者和肿瘤患者之间，该结果没有差异。
nTMS 足以用于临床，但评估者应努力最小化误差源。nTMS 在肿瘤患者中的可靠性与健康受试者相当。
