Rösler J, Niraula B, Strack V, Zdunczyk A, Schilt S, Savolainen P, Lioumis P, Mäkelä J, Vajkoczy P, Frey D, Picht T
Department of Neurosurgery, Charité University Hospital, Berlin, Germany.
Nexstim Ltd., Helsinki, Finland; Neuroscience Unit, Institute of Biomedicine/Physiology, University of Helsinki, Helsinki, Finland.
Clin Neurophysiol. 2014 Mar;125(3):526-36. doi: 10.1016/j.clinph.2013.08.015. Epub 2013 Sep 16.
This article explores the feasibility of a novel repetitive navigated transcranial magnetic stimulation (rnTMS) system and compares language mapping results obtained by rnTMS in healthy volunteers and brain tumor patients.
Fifteen right-handed healthy volunteers and 50 right-handed consecutive patients with left-sided gliomas were examined with a picture-naming task combined with time-locked rnTMS (5-10 Hz and 80-120% resting motor threshold) applied over both hemispheres. Induced errors were classified into four psycholinguistic types and assigned to their respective cortical areas according to the coil position during stimulation.
In healthy volunteers, language disturbances were almost exclusively induced in the left hemisphere. In patients errors were more frequent and induced at a comparative rate over both hemispheres. Predominantly dysarthric errors were induced in volunteers, whereas semantic errors were most frequent in the patient group.
The right hemisphere's increased sensitivity to rnTMS suggests reorganization in language representation in brain tumor patients.
rnTMS is a novel technology for exploring cortical language representation. This study proves the feasibility and safety of rnTMS in patients with brain tumor.
本文探讨一种新型重复导航经颅磁刺激（rnTMS）系统的可行性，并比较rnTMS在健康志愿者和脑肿瘤患者中获得的语言映射结果。
对15名右利手健康志愿者和50名连续的右利手左侧胶质瘤患者进行检查，采用图片命名任务并结合在双侧半球施加与时间锁定的rnTMS（5-10Hz和静息运动阈值的80-120%）。将诱发的错误分为四种心理语言学类型，并根据刺激期间的线圈位置将其分配到各自的皮质区域。
在健康志愿者中，语言障碍几乎仅在左半球诱发。在患者中，错误更频繁，且在双侧半球以相对较高的比率诱发。志愿者中主要诱发构音障碍性错误，而语义错误在患者组中最为常见。
右半球对rnTMS的敏感性增加表明脑肿瘤患者语言表征发生了重组。
rnTMS是一种探索皮质语言表征的新技术。本研究证明了rnTMS在脑肿瘤患者中的可行性和安全性。
