Comparison of direct cortical stimulation and transcranial magnetic stimulation in brain tumor surgery: systematic review and meta analyses

Introduction Brain malignancy and, at the same time central nervous system malignancy are two of the most difficult problems in the oncology field of practice. Brain tumors located near or within eloquent areas may represent another challenge toward neurosurgeon treatment. As such, electrical stimul...

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Bibliographic Details
Published in:Journal of neuro-oncology 2023-07, Vol.163 (3), p.505-514
Main Authors: Indharty, Rr. Suzy, Japardi, Iskandar, Irina, Rr. Sinta, Tandean, Steven, Siahaan, Andre Marolop Pangihutan, Loe, Michael Lumintang, Ivander, Alvin
Format: Article
Language:English
Subjects:
Brain cancer
Brain Mapping - methods
Brain Neoplasms - pathology
Brain Neoplasms - surgery
Brain tumors
Central nervous system
Electrical stimuli
Humans
Magnetic fields
Magnetic Resonance Imaging
Medicine
Medicine & Public Health
Meta-analysis
Neuroimaging
Neurology
Oncology
Patients
Quality of Life
Review
Surgery
Systematic review
Transcranial magnetic stimulation
Transcranial Magnetic Stimulation - methods
Wakefulness - physiology
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Summary:Introduction Brain malignancy and, at the same time central nervous system malignancy are two of the most difficult problems in the oncology field of practice. Brain tumors located near or within eloquent areas may represent another challenge toward neurosurgeon treatment. As such, electrical stimulation, either directly or through other methods, may prove necessary as proper mapping of the eloquent area thus may create a proper resection guide. Minimal resection will hopefully preserve patient neurological function and ensure patient quality of life. Methods This research is a systematic review and meta-analysis that aim to compare outcomes, primarily adverse event analysis, between direct cortical stimulation and transcortical magnetic stimulation. Results Fourteen studies were identified between 2010 and the 2023 interval. While this number is sufficient, most studies were not randomized and were not accompanied by blinding. Meta-analysis was then applied as a hypothesis test, which showed that TMS were not inferior compared to DCS in terms of motoric and lingual outcome which were marked subjectively by diamond location and objectively through a p-value above 0.05. Conclusion TMS is a noninvasive imaging method for the evaluation of eloquent brain areas that is not inferior compared to the invasive gold-standard imaging method (DCS). However its role as adjuvant to DCS and alternative only when awake surgery is not available must be emphasized.
ISSN:0167-594X
1573-7373
DOI:10.1007/s11060-023-04378-4