[ΒΟΟΚ] Navigated Transcranial Magnetic Stimulation in Neurosurgery – Βιβλία Google

Sandro Krieg Springer, 13 Ιουλ 2017 – 295 σελίδες This book is the first comprehensive work summarizing the advances that have been made in the neurosurgical use of navigated transcranial magnetic stimulation (nTMS) over the past ten years. Having increasingly gained acceptance as a presurgical mapping modality in neurosurgery, today it is widely used for preoperative mapping of cortical motor and language function, risk stratification and improving the accuracy of subcortical fiber bundle visualization.  This unique work will provide neurosurgeons and neuroscientists who are starting their nTMS program essential and detailed information on the technique and protocols, as well as the current clinical evidence on and limitations of the various applications of nTMS. At the same time, more experienced nTMS users looking for deeper insights into nTMS mapping and treatment in neurosurgery will find clearly structured, accessible information. The book was prepared by an international mix of authors, each of which was chosen for their status as a respected expert on the respective subtopic, as evinced by their landmark publications on nTMS. Προεπισκόπηση αυτού του βιβλίου »

Source: Navigated Transcranial Magnetic Stimulation in Neurosurgery – Βιβλία Google

[ARTICLE] Changing the clinical course of glioma patients by preoperative motor mapping with navigated transcranial magnetic brain stimulation – Full Text

Abstract

Background: Mapping of the motor cortex by navigated transcranial magnetic stimulation (nTMS) can be used for preoperative planning in brain tumor patients. Just recently, it has been proven to actually change outcomes by increasing the rate of gross total resection (GTR) and by reducing the surgery-related rate of paresis significantly in cohorts of patients suffering from different entities of intracranial lesions. Yet, we also need data that shows whether these changes also lead to a changed clinical course, and can also be achieved specifically in high-grade glioma (HGG) patients.

Methods: We prospectively enrolled 70 patients with supratentorial motor eloquently located HGG undergoing preoperative nTMS (2010–2014) and matched these patients with 70 HGG patients who did not undergo preoperative nTMS (2007–2010).

Results: On average, the overall size of the craniotomy was significantly smaller for nTMS patients when compared to the non-nTMS group (nTMS: 25.3 ± 9.7 cm2; non-nTMS: 30.8 ± 13.2 cm2; p = 0.0058). Furthermore, residual tumor tissue (nTMS: 34.3%; non-nTMS: 54.3%; p = 0.0172) and unexpected tumor residuals (nTMS: 15.7%; non-nTMS: 32.9%; p = 0.0180) were less frequent in nTMS patients. Regarding the further clinical course, median inpatient stay was 12 days for the nTMS and 14 days for the non-nTMS group (nTMS: CI 10.5 – 13.5 days; non-nTMS: CI 11.6 – 16.4 days; p = 0.0446). 60.0% of patients of the nTMS group and 54.3% of patients of the non-nTMS group were eligible for postoperative chemotherapy (OR 1.2630, CI 0.6458 – 2.4710, p = 0.4945), while 67.1% of nTMS patients and 48.6% of non-nTMS patients received radiotherapy (OR 2.1640, CI 1.0910 – 4.2910, p = 0.0261). Moreover, 3, 6, and 9 months survival was significantly better in the nTMS group (p = 0.0298, p = 0.0015, and p = 0.0167).

Conclusions: With the limitations of this study in mind, our data show that HGG patients might benefit from preoperative nTMS mapping.

Full Text —> BMC Cancer | Full text | Changing the clinical course of glioma patients by preoperative motor mapping with navigated transcranial magnetic brain stimulation.

[WEB SITE] Brain tumors: Mapping of motor areas in the brain by magnetic stimulation

A method known as navigated transcranial magnetic stimulation (nTMS) has been gaining importance in neurosurgery for some time now. Among other applications, it is used to map brain tumors before an operation and to test whether important regions of the brain, for example motor and language areas, are affected. Doctors at the Technische Universität München (TUM) have now shown that preoperative nTMS analysis of motor areas improves the prognosis of patients with malignant brain tumors.

With the help of nTMS, it is possible to identify what areas of the brain control motor or language function to an accuracy of four millimeters. “That’s particularly important, as it enables the removal of tumors from patients without affecting functional areas while at the same time removing as much of the malignant tissue as possible,” explains Dr. Sandro Krieg, working group leader at the Department of Neurosurgery of TUM University Hospital Klinikum rechts der Isar and head of the study. Mapping must be performed separately for each patient, as tumors can displace important brain areas from their original sites.

more —> Brain tumors: Mapping of motor areas in the brain by magnetic stimulation.

[WEB SITE] Nexstim – Navigated Brain Therapy

The Navigated Brain Therapy (NBT®) System is a device that uses navigated transcranial magnetic stimulation (nTMS) for use in stroke rehabilitation. Navigation is achieved by visualizing the electric field (e-field) generated by the TMS coil in a 3D image rendered from the patient’s MRI scan.

Stimulation intensity is calculated from the accurate measurement of brain excitability and the personal resting motor threshold (MT) of each patient. The proven accuracy confirms optimal treatment location for the individual patient, and ensures that stimulation treatment is always repeated at the same location, every time and for every session.

NBT® is currently being tested in a multicenter double-blinded, randomized, and sham-controlled trial. This new stroke therapy combines occupational therapy with nTMS. Called the NICHE trial (Navigated Inhibitory rTMS in Contralesional Hemisphere Evaluation), this study is being conducted at twelve of the top rehabilitation sites in the United States.

via Nexstim – Navigated Brain Therapy.

ARTICLE: Brain Stimulation Viable in Post-Stroke Rehab

…All patients treated with non-sham treatment showed signs of motor recovery after treatment. Those who received both low frequency to the unaffected hemisphere and high frequency to the affected hemisphere had significant recovery in spasticity, and patients who received just low frequency treatment or both frequencies of treatment showed improvement in activities of daily living…

μέσω Brain Stimulation Viable in Post-Stroke Rehab.