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For: Bowyer SM, Pang EW, Huang M, Papanicolaou AC, Lee RR. Presurgical Functional Mapping with Magnetoencephalography. Neuroimaging Clin N Am 2020;30:159-174. [DOI: 10.1016/j.nic.2020.02.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]

For:	Bowyer SM, Pang EW, Huang M, Papanicolaou AC, Lee RR. Presurgical Functional Mapping with Magnetoencephalography. Neuroimaging Clin N Am 2020;30:159-174. [DOI: 10.1016/j.nic.2020.02.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]

Number

Cited by Other Article(s)

Dmytriw AA, Hadjinicolaou A, Ntolkeras G, Tamilia E, Pesce M, Berto LF, Grant PE, Pang E, Ahtam B. Magnetoencephalography for the pediatric population, indications, acquisition and interpretation for the clinician. Neuroradiol J 2024:19714009241260801. [PMID: 38864180 DOI: 10.1177/19714009241260801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2024] Open

Fonseca N, Bowerman J, Askari P, Proskovec AL, Feltrin FS, Veltkamp D, Early H, Wagner BC, Davenport EM, Maldjian JA. Magnetoencephalography Atlas Viewer for Dipole Localization and Viewing. J Imaging 2024;10:80. [PMID: 38667978 PMCID: PMC11051542 DOI: 10.3390/jimaging10040080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 03/19/2024] [Accepted: 03/27/2024] [Indexed: 04/28/2024] Open

Affiliation(s)

N.C.d. Fonseca MEG Center of Excellence, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (P.A.); (A.L.P.); (F.S.F.); (D.V.); (H.E.); (E.M.D.); (J.A.M.) Advanced Neuroscience Imaging Research (ANSIR) Laboratory, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (J.B.); (B.C.W.) Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
Jason Bowerman Advanced Neuroscience Imaging Research (ANSIR) Laboratory, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (J.B.); (B.C.W.) Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
Pegah Askari MEG Center of Excellence, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (P.A.); (A.L.P.); (F.S.F.); (D.V.); (H.E.); (E.M.D.); (J.A.M.) Advanced Neuroscience Imaging Research (ANSIR) Laboratory, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (J.B.); (B.C.W.) Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA Biomedical Engineering Department, University of Texas Arlington, Arlington, TX 76019, USA Biomedical Engineering Department, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
Amy L. Proskovec MEG Center of Excellence, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (P.A.); (A.L.P.); (F.S.F.); (D.V.); (H.E.); (E.M.D.); (J.A.M.) Advanced Neuroscience Imaging Research (ANSIR) Laboratory, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (J.B.); (B.C.W.) Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
Fabricio Stewan Feltrin MEG Center of Excellence, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (P.A.); (A.L.P.); (F.S.F.); (D.V.); (H.E.); (E.M.D.); (J.A.M.) Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
Daniel Veltkamp MEG Center of Excellence, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (P.A.); (A.L.P.); (F.S.F.); (D.V.); (H.E.); (E.M.D.); (J.A.M.) Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
Heather Early MEG Center of Excellence, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (P.A.); (A.L.P.); (F.S.F.); (D.V.); (H.E.); (E.M.D.); (J.A.M.) Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
Ben C. Wagner Advanced Neuroscience Imaging Research (ANSIR) Laboratory, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (J.B.); (B.C.W.) Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
Elizabeth M. Davenport MEG Center of Excellence, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (P.A.); (A.L.P.); (F.S.F.); (D.V.); (H.E.); (E.M.D.); (J.A.M.) Advanced Neuroscience Imaging Research (ANSIR) Laboratory, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (J.B.); (B.C.W.) Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA Biomedical Engineering Department, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
Joseph A. Maldjian MEG Center of Excellence, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (P.A.); (A.L.P.); (F.S.F.); (D.V.); (H.E.); (E.M.D.); (J.A.M.) Advanced Neuroscience Imaging Research (ANSIR) Laboratory, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; (J.B.); (B.C.W.) Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA Biomedical Engineering Department, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA

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Noorizadeh N, Varner JA, Birg L, Williard T, Rezaie R, Wheless J, Narayana S. Comparing the efficacy of awake and sedated MEG to TMS in mapping hand sensorimotor cortex in a clinical cohort. Neuroimage Clin 2024;41:103562. [PMID: 38215622 PMCID: PMC10821581 DOI: 10.1016/j.nicl.2024.103562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 11/19/2023] [Accepted: 01/07/2024] [Indexed: 01/14/2024]

Mishra R, Mariyappa N, Rao Malla B, Arivazhagan A, Mishra B, Gautham B, Chowdary Mundlamuri R, Jayabal V, Raghavendra K, Asranna A, Viswanathan LG, Sadashiva N, Bharath RD, Saini J, Nagaraj C, Mangalore S, Karthik K, Rajeswaran J, Kumar K, Mahadevan A, Sinha S. Localisation of eloquent cortex using magnetoencephalography and its clinical implications. Int J Neurosci 2023:1-13. [PMID: 37824719 DOI: 10.1080/00207454.2023.2270684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 10/09/2023] [Indexed: 10/14/2023]

Vitulli F, Kalaitzoglou D, Soumpasis C, Díaz-Baamonde A, Mosquera JDS, Gullan R, Vergani F, Ashkan K, Bhangoo R, Mirallave-Pescador A, Lavrador JP. Cortical-Subcortical Functional Preservation and Rehabilitation in Neuro-Oncology: Tractography-MIPS-IONM-TMS Proof-of-Concept Study. J Pers Med 2023;13:1278. [PMID: 37623528 PMCID: PMC10455135 DOI: 10.3390/jpm13081278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 08/10/2023] [Accepted: 08/16/2023] [Indexed: 08/26/2023] Open

Abstract

Surgical management of deep-seated brain tumors requires precise functional navigation and minimally invasive surgery. Preoperative mapping using navigated transcranial magnetic stimulation (nTMS), intraoperative neurophysiological monitoring (IONM), and minimally invasive parafascicular surgery (MIPS) act together in a functional-sparing approach. nTMS also provides a rehabilitation tool to maximize functional recovery. This is a single-center retrospective proof-of-concept cohort study between January 2022 and June 2023 of patients admitted for surgery with motor eloquent deep-seated brain tumors. The study enrolled seven adult patients, five females and two males, with a mean age of 56.28 years old. The lesions were located in the cingulate gyrus (three patients), the central core (two patients), and the basal ganglia (two patients). All patients had preoperative motor deficits. The most common histological diagnosis was metastasis (five patients). The MIPS approach to the mid-cingulate lesions involved a trajectory through the fronto-aslant tract (FAT) and the fronto-striatal tract (FST). No positive nTMS motor responses were resected as part of the outer corridor for MIPS. Direct cortical stimulation produced stable motor-evoked potentials during the surgeries with no warning signs. Gross total resection (GTR) was achieved in three patients and near-total resection (NTR) in four patients. Post-operatively, all patients had a deterioration of motor function with no ischemia in the postoperative imaging (cavity-to-CST distance 0-4 mm). After nTMS with low-frequency stimulation in the contralateral motor cortex, six patients recovered to their preoperative functional status and one patient improved to a better functional condition. A combined Tractography-MIPS-IONM-TMS approach provides a successful functional-sparing approach to deep-seated motor eloquent tumors and a rehabilitation framework for functional recovery after surgery.

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Affiliation(s)

Francesca Vitulli Department of Neurosurgery, King’s College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, UK; (F.V.); (C.S.); (R.G.); (F.V.); (K.A.); (R.B.); (A.M.-P.); (J.P.L.) Department of Neurosciences and Reproductive and Dental Sciences, Division of Neurosurgery, University of Naples, “Federico II”, Via S. Pansini, 80131 Naples, Italy
Dimitrios Kalaitzoglou Department of Neurosurgery, King’s College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, UK; (F.V.); (C.S.); (R.G.); (F.V.); (K.A.); (R.B.); (A.M.-P.); (J.P.L.)
Christos Soumpasis Department of Neurosurgery, King’s College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, UK; (F.V.); (C.S.); (R.G.); (F.V.); (K.A.); (R.B.); (A.M.-P.); (J.P.L.)
Alba Díaz-Baamonde Department of Neurophysiology, King’s College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, UK; (A.D.-B.); (J.D.S.M.)
José David Siado Mosquera Department of Neurophysiology, King’s College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, UK; (A.D.-B.); (J.D.S.M.)
Richard Gullan Department of Neurosurgery, King’s College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, UK; (F.V.); (C.S.); (R.G.); (F.V.); (K.A.); (R.B.); (A.M.-P.); (J.P.L.)
Francesco Vergani Department of Neurosurgery, King’s College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, UK; (F.V.); (C.S.); (R.G.); (F.V.); (K.A.); (R.B.); (A.M.-P.); (J.P.L.)
Keyoumars Ashkan Department of Neurosurgery, King’s College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, UK; (F.V.); (C.S.); (R.G.); (F.V.); (K.A.); (R.B.); (A.M.-P.); (J.P.L.)
Ranjeev Bhangoo Department of Neurosurgery, King’s College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, UK; (F.V.); (C.S.); (R.G.); (F.V.); (K.A.); (R.B.); (A.M.-P.); (J.P.L.)
Ana Mirallave-Pescador Department of Neurosurgery, King’s College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, UK; (F.V.); (C.S.); (R.G.); (F.V.); (K.A.); (R.B.); (A.M.-P.); (J.P.L.) Department of Neurophysiology, King’s College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, UK; (A.D.-B.); (J.D.S.M.)
Jose Pedro Lavrador Department of Neurosurgery, King’s College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, UK; (F.V.); (C.S.); (R.G.); (F.V.); (K.A.); (R.B.); (A.M.-P.); (J.P.L.)

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Tyner K, Das S, McCumber M, Alfatlawi M, Gliske SV. An Automated Algorithm for the Identification of Somatosensory Cortex Using Magnetoencephalography. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2023;2023:1-4. [PMID: 38082586 DOI: 10.1109/embc40787.2023.10340978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]

Huang MX, Harrington DL, Angeles-Quinto A, Ji Z, Robb-Swan A, Huang CW, Shen Q, Hansen H, Baumgartner J, Hernandez-Lucas J, Nichols S, Jacobus J, Song T, Lerman I, Bazhenov M, Krishnan GP, Baker DG, Rao R, Lee RR. EMG-projected MEG High-Resolution Source Imaging of Human Motor Execution: Brain-Muscle Coupling above Movement Frequencies. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.06.23.23291825. [PMID: 37425691 PMCID: PMC10327237 DOI: 10.1101/2023.06.23.23291825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]

Affiliation(s)

Ming-Xiong Huang Radiology, Research, and Psychiatry Services, VA San Diego Healthcare System, San Diego, CA, USA Department of Radiology, University of California, San Diego, CA, USA Department of Electrical and Computer Engineering, University of California, San Diego, CA, USA
Deborah L. Harrington Radiology, Research, and Psychiatry Services, VA San Diego Healthcare System, San Diego, CA, USA Department of Radiology, University of California, San Diego, CA, USA
Annemarie Angeles-Quinto Department of Radiology, University of California, San Diego, CA, USA
Zhengwei Ji Department of Radiology, University of California, San Diego, CA, USA
Ashley Robb-Swan Department of Radiology, University of California, San Diego, CA, USA
Charles W. Huang Department of Bioengineering, Stanford University, Stanford, CA, USA
Qian Shen Department of Radiology, University of California, San Diego, CA, USA
Hayden Hansen Department of Radiology, University of California, San Diego, CA, USA
Jared Baumgartner Radiology, Research, and Psychiatry Services, VA San Diego Healthcare System, San Diego, CA, USA
Jaqueline Hernandez-Lucas Radiology, Research, and Psychiatry Services, VA San Diego Healthcare System, San Diego, CA, USA
Sharon Nichols Department of Neurosciences, University of California, San Diego, CA, USA
Joanna Jacobus Department of Psychiatry, University of California, San Diego, CA, USA
Tao Song Department of Radiology, University of California, San Diego, CA, USA
Imanuel Lerman Radiology, Research, and Psychiatry Services, VA San Diego Healthcare System, San Diego, CA, USA
Maksim Bazhenov Department of Medicine, University of California, San Diego, CA, USA
Giri P Krishnan Department of Medicine, University of California, San Diego, CA, USA
Dewleen G. Baker Radiology, Research, and Psychiatry Services, VA San Diego Healthcare System, San Diego, CA, USA Department of Psychiatry, University of California, San Diego, CA, USA VA Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, USA
Ramesh Rao Department of Electrical and Computer Engineering, University of California, San Diego, CA, USA
Roland R. Lee Radiology, Research, and Psychiatry Services, VA San Diego Healthcare System, San Diego, CA, USA Department of Radiology, University of California, San Diego, CA, USA

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Babajani-Feremi A, Pourmotabbed H, Schraegle WA, Calley CS, Clarke DF, Papanicolaou AC. MEG language mapping using a novel automatic ECD algorithm in comparison with MNE, dSPM, and DICS beamformer. Front Neurosci 2023;17:1151885. [PMID: 37332870 PMCID: PMC10272516 DOI: 10.3389/fnins.2023.1151885] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 04/24/2023] [Indexed: 06/20/2023] Open

Abstract

Introduction

The single equivalent current dipole (sECD) is the standard clinical procedure for presurgical language mapping in epilepsy using magnetoencephalography (MEG). However, the sECD approach has not been widely used in clinical assessments, mainly because it requires subjective judgements in selecting several critical parameters. To address this limitation, we developed an automatic sECD algorithm (AsECDa) for language mapping.

Methods

The localization accuracy of the AsECDa was evaluated using synthetic MEG data. Subsequently, the reliability and efficiency of AsECDa were compared to three other common source localization methods using MEG data recorded during two sessions of a receptive language task in 21 epilepsy patients. These methods include minimum norm estimation (MNE), dynamic statistical parametric mapping (dSPM), and dynamic imaging of coherent sources (DICS) beamformer.

Results

For the synthetic single dipole MEG data with a typical signal-to-noise ratio, the average localization error of AsECDa was less than 2 mm for simulated superficial and deep dipoles. For the patient data, AsECDa showed better test-retest reliability (TRR) of the language laterality index (LI) than MNE, dSPM, and DICS beamformer. Specifically, the LI calculated with AsECDa revealed excellent TRR between the two MEG sessions across all patients (Cor = 0.80), while the LI for MNE, dSPM, DICS-event-related desynchronization (ERD) in the alpha band, and DICS-ERD in the low beta band ranged lower (Cor = 0.71, 0.64, 0.54, and 0.48, respectively). Furthermore, AsECDa identified 38% of patients with atypical language lateralization (i.e., right lateralization or bilateral), compared to 73%, 68%, 55%, and 50% identified by DICS-ERD in the low beta band, DICS-ERD in the alpha band, MNE, and dSPM, respectively. Compared to other methods, AsECDa's results were more consistent with previous studies that reported atypical language lateralization in 20-30% of epilepsy patients.

Discussion

Our study suggests that AsECDa is a promising approach for presurgical language mapping, and its fully automated nature makes it easy to implement and reliable for clinical evaluations.

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Maldjian JA, Lee R, Jordan J, Davenport EM, Proskovec AL, Wintermark M, Stufflebeam S, Anderson J, Mukherjee P, Nagarajan SS, Ferrari P, Gaetz W, Schwartz E, Roberts TPL. ACR White Paper on Magnetoencephalography and Magnetic Source Imaging: A Report from the ACR Commission on Neuroradiology. AJNR Am J Neuroradiol 2022;43:E46-E53. [PMID: 36456085 DOI: 10.3174/ajnr.a7714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 10/04/2022] [Indexed: 12/04/2022]

Affiliation(s)

J A Maldjian From the Advanced Neuroscience Imaging Research Laboratory (J.A.M., E.M.D., A.L.P.) .,MEG Center of Excellence (J.A.M., E.M.D., A.L.P.).,Department of Radiology (J.A.M., E.M.D., A.L.P.), University of Texas Southwestern Medical Center, Dallas, Texas
R Lee Department of Neuroradiology (R.L.), University of California San Diego, San Diego, California
J Jordan ACR Commission on Neuroradiology (J.J.), American College of Radiology, Reston, Virginia.,Stanford University School of Medicine (J.J.), Stanford, California
E M Davenport From the Advanced Neuroscience Imaging Research Laboratory (J.A.M., E.M.D., A.L.P.).,MEG Center of Excellence (J.A.M., E.M.D., A.L.P.).,Department of Radiology (J.A.M., E.M.D., A.L.P.), University of Texas Southwestern Medical Center, Dallas, Texas
A L Proskovec From the Advanced Neuroscience Imaging Research Laboratory (J.A.M., E.M.D., A.L.P.).,MEG Center of Excellence (J.A.M., E.M.D., A.L.P.).,Department of Radiology (J.A.M., E.M.D., A.L.P.), University of Texas Southwestern Medical Center, Dallas, Texas
M Wintermark Department of Neuroradiology (M.W.), University of Texas MD Anderson Center, Houston, Texas
S Stufflebeam Athinoula A. Martinos Center for Biomedical Imaging (S.S.), Department of Radiology, Massachusetts General Hospital, Charlestown, Massachusetts
J Anderson Department of Radiology and Imaging Sciences (J.A.), University of Utah School of Medicine, Salt Lake City, Utah
P Mukherjee Department of Radiology and Biomedical Imaging (P.M., S.S.N.), University of California, San Francisco, San Francisco, California
S S Nagarajan Department of Radiology and Biomedical Imaging (P.M., S.S.N.), University of California, San Francisco, San Francisco, California
P Ferrari Pediatric Neurosciences (P.F.), Helen DeVos Children's Hospital, Grand Rapids, Michigan.,Department of Pediatrics and Human Development (P.F.), College of Human Medicine, Michigan State University, Grand Rapids, Michigan
W Gaetz Department of Radiology (W.G., E.S., T.P.L.R.), Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
E Schwartz Department of Radiology (W.G., E.S., T.P.L.R.), Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
T P L Roberts Department of Radiology (W.G., E.S., T.P.L.R.), Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania

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Weiss Lucas C, Faymonville AM, Loução R, Schroeter C, Nettekoven C, Oros-Peusquens AM, Langen KJ, Shah NJ, Stoffels G, Neuschmelting V, Blau T, Neuschmelting H, Hellmich M, Kocher M, Grefkes C, Goldbrunner R. Surgery of Motor Eloquent Glioblastoma Guided by TMS-Informed Tractography: Driving Resection Completeness Towards Prolonged Survival. Front Oncol 2022;12:874631. [PMID: 35692752 PMCID: PMC9186060 DOI: 10.3389/fonc.2022.874631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 03/21/2022] [Indexed: 12/13/2022] Open

Abstract

Background

Surgical treatment of patients with glioblastoma affecting motor eloquent brain regions remains critically discussed given the risk–benefit dilemma of prolonging survival at the cost of motor-functional damage. Tractography informed by navigated transcranial magnetic stimulation (nTMS-informed tractography, TIT) provides a rather robust estimate of the individual location of the corticospinal tract (CST), a highly vulnerable structure with poor functional reorganisation potential. We hypothesised that by a more comprehensive, individualised surgical decision-making using TIT, tumours in close relationship to the CST can be resected with at least equal probability of gross total resection (GTR) than less eloquently located tumours without causing significantly more gross motor function harm. Moreover, we explored whether the completeness of TIT-aided resection translates to longer survival.

Methods

A total of 61 patients (median age 63 years, m = 34) with primary glioblastoma neighbouring or involving the CST were operated on between 2010 and 2015. TIT was performed to inform surgical planning in 35 of the patients (group T; vs. 26 control patients). To achieve largely unconfounded group comparisons for each co-primary outcome (i.e., gross-motor functional worsening, GTR, survival), (i) uni- and multivariate regression analyses were performed to identify features of optimal outcome prediction; (ii), optimal propensity score matching (PSM) was applied to balance those features pairwise across groups, followed by (iii) pairwise group comparison.

Results

Patients in group T featured a significantly higher lesion-CST overlap compared to controls (8.7 ± 10.7% vs. 3.8 ± 5.7%; p = 0.022). The frequency of gross motor worsening was higher in group T, albeit non-significant (n = 5/35 vs. n = 0/26; p = 0.108). PSM-based paired-sample comparison, controlling for the confounders of preoperative tumour volume and vicinity to the delicate vasculature of the insula, showed higher GTR rates in group T (77% vs. 69%; p = 0.025), particularly in patients with a priori intended GTR (87% vs. 78%; p = 0.003). This translates into a prolonged PFS in the same PSM subgroup (8.9 vs. 5.8 months; p = 0.03), with GTR representing the strongest predictor of PFS (p = 0.001) and OS (p = 0.0003) overall.

Conclusion

The benefit of TIT-aided GTR appears to overcome the drawbacks of potentially elevated motor functional risk in motor eloquent tumour localisation, leading to prolonged survival of patients with primary glioblastoma close to the CST.

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Affiliation(s)

Carolin Weiss Lucas Department of General Neurosurgery, Center of Neurosurgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
Andrea Maria Faymonville Department of General Neurosurgery, Center of Neurosurgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,Department of Neurosurgery, University Hospital Mannheim, Mannheim, Germany
Ricardo Loução Department of General Neurosurgery, Center of Neurosurgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,Department of Stereotaxy and Functional Neurosurgery, Center of Neurosurgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,Institute of Neuroscience and Medicine (INM-4), Forschungszentrum Julich, Juelich, Germany
Catharina Schroeter Department of General Neurosurgery, Center of Neurosurgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
Charlotte Nettekoven Department of General Neurosurgery, Center of Neurosurgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
Ana-Maria Oros-Peusquens Institute of Neuroscience and Medicine (INM-4), Forschungszentrum Julich, Juelich, Germany
Karl Josef Langen Institute of Neuroscience and Medicine (INM-4), Forschungszentrum Julich, Juelich, Germany
N Jon Shah Institute of Neuroscience and Medicine (INM-4), Forschungszentrum Julich, Juelich, Germany.,JARA - BRAIN - Translational Medicine, Aachen, Germany.,Department of Neurology, RWTH Aachen University, Aachen, Germany
Gabriele Stoffels Institute of Neuroscience and Medicine (INM-4), Forschungszentrum Julich, Juelich, Germany
Volker Neuschmelting Department of General Neurosurgery, Center of Neurosurgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
Tobias Blau Department of Neurology, RWTH Aachen University, Aachen, Germany.,Institute of Neuropathology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
Hannah Neuschmelting Institute of Pathology and Neuropathology, University Hospital Essen, Essen, Germany
Martin Hellmich Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
Martin Kocher Department of General Neurosurgery, Center of Neurosurgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,Department of Stereotaxy and Functional Neurosurgery, Center of Neurosurgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,Institute of Neuroscience and Medicine (INM-4), Forschungszentrum Julich, Juelich, Germany
Christian Grefkes Institute of Neuroscience and Medicine (INM-4), Forschungszentrum Julich, Juelich, Germany.,Institute for Medical Statistics and Computational Biology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
Roland Goldbrunner Department of General Neurosurgery, Center of Neurosurgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany

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Spooner RK, Madhavan D, Aizenberg MR, Wilson TW. Retrospective comparison of motor and somatosensory MEG mapping-Considerations for better clinical applications. Neuroimage Clin 2022;35:103045. [PMID: 35597033 PMCID: PMC9123261 DOI: 10.1016/j.nicl.2022.103045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 04/29/2022] [Accepted: 05/09/2022] [Indexed: 11/17/2022]

Abstract

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MEG is a clinically validated tool for presurgical functional mapping.

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The success rate for MEG somatosensory and motor mapping is not fully known.

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Comprehensive mapping protocols increase the accuracy of sensorimotor mapping.

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Major sources of mapping failures include low SNR, magnetic artifacts, and motion.

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Recommendations for improving mapping success rates in the future are discussed.

While magnetoencephalography (MEG) has proven to be a valuable and reliable tool for presurgical functional mapping of eloquent cortices for at least two decades, widespread use of this technique by clinicians has remained elusive. This modest application may be attributable, at least in part, to misunderstandings regarding the success rate of such mapping procedures, as well as the primary sources contributing to mapping failures. To address this, we conducted a retrospective comparison of sensorimotor functional mapping success rates in 141 patients with epilepsy and 75 tumor patients from the Center for MEG in Omaha, NE. Neurosurgical candidates either completed motor mapping (i.e., finger tapping paradigm), somatosensory mapping (i.e., peripheral stimulation paradigm), or both motor and somatosensory protocols during MEG. All MEG data underwent subsequent time-domain averaging and source localization of left and right primary motor (M1) and somatosensory (S1) cortices was conducted using a single equivalent dipole model. Successful mapping was determined based on dipole goodness of fit metrics ∼ 95%, as well as an accurate and conceivable spatial correspondence to precentral and postcentral gyri for M1 and S1, respectively. Our results suggest that mapping M1 in epilepsy and tumor patients was on average 94.5% successful, when patients only completed motor mapping protocols. In contrast, mapping S1 was successful 45–100% of the time in these patient groups when they only completed somatosensory mapping paradigms. Importantly, Z-tests for independent proportions revealed that the percentage of successful S1 mappings significantly increased to ∼ 94% in epilepsy patients who completed both motor/somatosensory mapping protocols during MEG. Together, these data suggest that ordering more comprehensive mapping procedures (e.g., both motor and somatosensory protocols for a collective sensorimotor network) may substantially increase the accuracy of presurgical functional mapping by providing more extensive data from which to base interpretations. Moreover, clinicians and magnetoencephalographers should be considerate of the major contributors to mapping failures (i.e., low SNR, excessive motion and magnetic artifacts) in order to further increase the percentage of cases achieving successful mapping of eloquent cortices.

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Otsubo H, Ogawa H, Pang E, Wong SM, Ibrahim GM, Widjaja E. A review of magnetoencephalography use in pediatric epilepsy: an update on best practice. Expert Rev Neurother 2021;21:1225-1240. [PMID: 33780318 DOI: 10.1080/14737175.2021.1910024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]