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Assessing the feasibility of mapping the tibialis anterior muscle with navigated transcranial magnetic stimulation in neuro-oncologic patients
Mapping the lower extremity with navigated transcranial magnetic stimulation (nTMS) still remains challenging for the investigator. Clinical factors influencing leg mapping with nTMS have not been fully investigated yet. The aim of the study was to identify factors which influence the possibility of...
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Published in: | Scientific reports 2022-11, Vol.12 (1), p.18719-18719, Article 18719 |
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Main Authors: | , , , , , , , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites Items that cite this one |
Online Access: | Get full text |
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Summary: | Mapping the lower extremity with navigated transcranial magnetic stimulation (nTMS) still remains challenging for the investigator. Clinical factors influencing leg mapping with nTMS have not been fully investigated yet. The aim of the study was to identify factors which influence the possibility of eliciting motor evoked potentials (MEPs) from the tibialis anterior muscle (TA). Patient records, imaging, nTMS examinations and tractography were retrospectively evaluated. 48 nTMS examinations were performed in 46 brain tumor patients. Reproducible MEPs were recorded in 20 patients (41.67%). Younger age (
p
= 0.044) and absence of perifocal edema (
p
= 0.035, Cramer’s V = 0.34, OR = 0.22, 95% CI = 0.06–0.81) facilitated mapping the TA muscle. Leg motor deficit (
p
= 0.49, Cramer’s V = 0.12, OR = 0.53, 95%CI = 0.12–2.36), tumor entity (
p
= 0.36, Cramer’s V = 0.22), tumor location (
p
= 0.52, Cramer’s V = 0.26) and stimulation intensity (
p
= 0.158) were no significant factors. The distance between the tumor and the pyramidal tract was higher (
p
= 0.005) in patients with successful mapping of the TA. The possibility to stimulate the leg motor area was associated with no postoperative aggravation of motor deficits in general (
p
= 0.005, Cramer’s V = 0.45, OR = 0.63, 95%CI = 0.46–0.85) but could not serve as a specific predictor of postoperative lower extremity function. In conclusion, successful mapping of the TA muscle for neurosurgical planning is influenced by young patient age, absence of edema and greater distance to the CST, whereas tumor entity and stimulation intensity were non-significant. |
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ISSN: | 2045-2322 2045-2322 |
DOI: | 10.1038/s41598-022-23444-x |