Study Design for Navigated Repetitive Transcranial Magnetic Stimulation for Speech Cortical Mapping.

The cortical areas involved in human speech should be characterized reliably prior to surgery for brain tumors or drug-resistant epilepsy. The functional mapping of language areas for surgical decision-making is usually done invasively by electrical direct cortical stimulation (DCS), which is used to identify the organization of the crucial cortical and subcortical structures within each patient. Accurate preoperative non-invasive mapping aids surgical planning, reduces time, costs, and risks in the operating room, and provides an alternative for patients not suitable for awake craniotomy.

Accuracy and precision of navigated transcranial magnetic stimulation.

Transcranial magnetic stimulation (TMS) induces an electric field (E-field) in the cortex. To facilitate stimulation targeting, image-guided neuronavigation systems have been introduced. Such systems track the placement of the coil with respect to the head and visualize the estimated cortical stimulation location on an anatomical brain image in real time.

A Randomized, Sham-Controlled Trial of Repetitive Transcranial Magnetic Stimulation Targeting M1 and S2 in Central Poststroke Pain: A Pilot Trial.

Objectives: Central poststroke pain (CPSP), a neuropathic pain condition, is difficult to treat. Repetitive transcranial magnetic stimulation (rTMS) targeted to the primary motor cortex (M1) can alleviate the condition, but not all patients respond. We aimed to assess a promising alternative rTMS target, the secondary somatosensory cortex (S2), for CPSP treatment.

Analgesic effect of paired associative stimulation in a tetraplegic patient with severe drug-resistant neuropathic pain: a case report.

Objectives: There is no effective evidence-based non-pharmacological treatment for severe neuropathic pain after spinal cord injury (SCI). Paired associative stimulation (PAS) has been used in motor rehabilitation of patients after SCI. In the SCI-PAS protocol for tetraplegic patients, peripheral and central nerve tracts are activated with subject-specific timing, such that ascending and descending signals appear simultaneously at the cervical level.

Transcranial magnetic stimulation-evoked potentials after the stimulation of the right-hemispheric homologue of Broca's area.

The combination of transcranial magnetic stimulation and electroencephalography can be applied to probe effective connectivity. Neurons are excited by magnetic pulses, which produce transcranial magnetic stimulation-evoked potentials that can be monitored with electroencephalography. Effective connectivity refers to causal connections in the brain; it describes how different brain areas communicate with each other.

EEG Artifact Removal in TMS Studies of Cortical Speech Areas.

The combination of transcranial magnetic stimulation (TMS) and electroencephalography (EEG) is commonly applied for studying the effective connectivity of neuronal circuits. The stimulation excites neurons, and the resulting TMS-evoked potentials (TEPs) are recorded with EEG. A serious obstacle in this method is the generation of large muscle artifacts from scalp muscles, especially when frontolateral and temporoparietal, such as speech, areas are stimulated.

The effect of experimental pain on short-interval intracortical inhibition with multi-locus transcranial magnetic stimulation.

Chronic neuropathic pain is known to alter the primary motor cortex (M1) function. Less is known about the normal, physiological effects of experimental neurogenic pain on M1. The objective of this study is to determine how short-interval intracortical inhibition (SICI) is altered in the M1 representation area of a muscle exposed to experimental pain compared to SICI of another muscle not exposed to pain.

Individual Activation Patterns After the Stimulation of Different Motor Areas: A Transcranial Magnetic Stimulation-Electroencephalography Study.

The combination of transcranial magnetic stimulation (TMS) and electroencephalography (EEG) enables one to study effective connectivity and activation order in neuronal networks. To characterize effective connectivity originating from the primary motor cortex (M1), dorsal premotor area (PMd), and supplementary motor area (SMA). Three right-handed volunteers (two men, aged 25-30 years) participated in a navigated TMS-EEG experiment.

Protocol for motor and language mapping by navigated TMS in patients and healthy volunteers; workshop report.

Introduction: Navigated transcranial magnetic stimulation (nTMS) is increasingly used for preoperative mapping of motor function, and clinical evidence for its benefit for brain tumor patients is accumulating. In respect to language mapping with repetitive nTMS, literature reports have yielded variable results, and it is currently not routinely performed for presurgical language localization. The aim of this project is to define a common protocol for nTMS motor and language mapping to standardize its neurosurgical application and increase its clinical value.

Functional and structural cortical characteristics after restricted focal motor cortical infarction evaluated at chronic stage - Indications from a preliminary study.

Objective: To assess the inter-hemispheric differences in neuronal function and structure of the motor cortex in a small group of chronic stroke patients having suffered a restricted ischemic lesion affecting hand motor representation. GABAergic intracortical inhibition, known to be affected by stroke lesion, was also investigated.

Methods: Eight patients exhibiting little or no motor impairment were studied using transcranial magnetic stimulation (TMS) and diffusion weighted imaging (DWI) >15months from diagnosis.

Increased Inhibition in Non-Primary Motor Areas of String-Instrument Players: A Preliminary Study with Paired-Pulse Transcranial Magnetic Stimulation.

The muscle representations in non-primary motor area (NPMA) are located in the dorsal premotor area (PMd) and in the border region between the premotor area and the supplementary motor area (SMA). We characterized the plasticity of intracortical inhibitory and excitatory circuits in muscle representations in primary motor cortex (M1) and in NPMA related to acquired fine motor skills. We compared local cortical inhibition and facilitation balance in M1 and in NPMA between control subjects ( = 6) and right-handed string-instrument players ( = 5).

Reactivity of sensorimotor oscillations is altered in children with hemiplegic cerebral palsy: A magnetoencephalographic study.

Cerebral palsy (CP) is characterized by difficulty in control of movement and posture due to brain damage during early development. In addition, tactile discrimination deficits are prevalent in CP. To study the function of somatosensory and motor systems in CP, we compared the reactivity of sensorimotor cortical oscillations to median nerve stimulation in 12 hemiplegic CP children vs.

Long-term plasticity may be manifested as reduction or expansion of cortical representations of actively used muscles in motor skill specialists.

Our aim was to study long-term plasticity in the organization of cortical muscle representations due to extensive motor training for different skills. We were especially interested in whether skill-specific demands on independent hand muscle movements and synchronous leg muscle movements are reflected differently in the reorganization of muscle representations. We used navigated transcranial magnetic stimulation to estimate the size of cortical representations of opponens pollicis, abductor digiti minimi, and tibialis anterior muscles in five string instrument players, five figure skaters, and five controls.

Corticospinal output and cortical excitation-inhibition balance in distal hand muscle representations in nonprimary motor area.

Transcranial magnetic stimulation (TMS) of the superior frontal gyrus in the non-primary motor area (NPMA) can evoke motor-evoked potentials (MEPs) at 20 ms latency range in contralateral distal hand muscles similar to stimulation of M1 and indicating monosynaptic corticospinal tracts. We compared the intracortical inhibitory and excitatory balance in primary motor cortex (M1) and in NPMA by navigated single- and paired-pulse TMS (ppTMS). We also evaluated the spatial stability of muscle representations in M1 and NPMA by remapping 11 healthy subjects one year after the initial mapping.