Fang Xiaojing, Liu Meige, Lu Changyu, Zhao Yuanli, Liu Xianzeng
Department of Neurology, Peking University International Hospital, 1 Life Science St, Changping District, Beijing, 102206 China.
Department of Neurology, Peking University People's Hospital, Beijing, 100044 China.
Chin Neurosurg J. 2019 May 21;5:12. doi: 10.1186/s41016-019-0159-6. eCollection 2019.
Transcranial magnetic stimulation (TMS) is a noninvasive neurophysiologic technique that can stimulate the human brain. Positioning of the coil was often performed based merely on external landmarks on the head, meaning that the anatomical target in the cortex remains inaccurate. Navigated transcranial magnetic stimulation (nTMS) combines a frameless stereotactic navigational system and TMS coil and can provide a highly accurate delivery of TMS pulses with the guidance of imaging. Therefore, many novel utilities for TMS could be explored due to the ability of precise localization. Many studies have been published, which indicate nTMS enables presurgical functional mapping. This review aimed to provide a comprehensive literature review on nTMS, especially the principles and clinical applications of nTMS. All articles in PubMed with keywords of "motor mapping," "presurgical mapping," "navigated transcranial magnetic stimulation," and "language mapping" published from 2000 to 2018 were included in the study. Frequently cited publications before 2000 were also included. The most valuable published original and review articles related to our objective were selected. Motor mapping of nTMS is validated to be a trustful tool to recognize functional areas belonging to both normal and lesioned primary motor cortex. It can offer reliable mapping of speech and motor regions at cortex prior to operation and has comparable accuracy as direct electrical cortical stimulation. nTMS is a powerful tool for mapping of motor and linguistic function prior to operation, has high application value in neurosurgery and the treatment of neurological and psychiatric diseases, and has gained increasing acceptance in neurosurgical centers across the world.
经颅磁刺激（TMS）是一种能够刺激人脑的非侵入性神经生理学技术。线圈的定位通常仅基于头部的外部标志进行，这意味着皮质中的解剖学靶点仍不准确。导航经颅磁刺激（nTMS）将无框架立体定向导航系统与TMS线圈相结合，能够在成像引导下高度精确地递送TMS脉冲。因此，由于其精确的定位能力，可以探索TMS的许多新用途。已经发表了许多研究，表明nTMS能够进行术前功能图谱绘制。本综述旨在对nTMS进行全面的文献综述，尤其是nTMS的原理和临床应用。本研究纳入了2000年至2018年发表在PubMed上的所有关键词为“运动图谱”“术前图谱”“导航经颅磁刺激”和“语言图谱”的文章。2000年之前经常被引用的出版物也被纳入。选择了与我们的目标相关的最有价值的已发表原创文章和综述文章。nTMS的运动图谱已被验证是识别正常和病变初级运动皮质功能区域的可靠工具。它可以在手术前提供可靠的皮质言语和运动区域图谱，并且与直接皮质电刺激具有相当的准确性。nTMS是手术前运动和语言功能图谱绘制的有力工具，在神经外科以及神经和精神疾病的治疗中具有很高的应用价值，并且在世界各地的神经外科中心越来越受到认可。
