Introducing navigated transcranial magnetic stimulation as a refined brain mapping methodology
Introducing navigated transcranial magnetic stimulation as a refined brain mapping methodology
复制标题
DOI：
10.1007/s101430100151
复制
发表时间：
2001-12-01
影响因子：
2.8
通讯作者：
Thron, A
中科院分区：
文献类型：
--
作者：
Krings, T;Chiappa, KH;Thron, A
经颅磁刺激（TMS）绘制人脑图的一个主要内在限制在于刺激线圈在头皮上的位置与底层受刺激皮层之间的关系不明确。结构和功能之间的关系是构成脑映射模式的主要特征，因此不能建立。图像处理的最新进展使我们能够通过将磁共振成像（MRI）模式与颅磁刺激相结合，使用神经导航系统来测量刺激线圈的位置，并将该位置映射到MRI数据集上，从而改进颅磁刺激。与最近的TMS映射策略相比，该技术有几个优点。通过实时视觉引导，线圈在头皮上的位置可以保持恒定。在评估高级皮层功能时，可以准确评估底层皮层解剖结构与头皮刺激部位之间的关系。皮质运动输出图可以很容易地获得术前计划和决策的肿块病变患者罗兰皮质附近。总之，导航经颅磁刺激是定位皮质功能的可靠替代方法，因此可能是一种有用的辅助方法，或者在某些患者中甚至是其他功能性神经成像方法的有用替代方法。
A major intrinsic limitation of transcranial magnetic stimulation (TMS) to map the human brain lies in the unclear relationship between the position of the stimulating coil on the scalp and the underlying stimulated cortex. The relationship between structure and function as the major feature constituting a brain mapping modality can therefore not be established. Recent advances in image processing allowed us to refine TMS by combining magnetic resonance imaging (MRI) modalities with TMS using a neuronavigation system to measure the position of the stimulating coil and map this position onto a MRI data set. This technique has several advantages over recent TMS mapping strategies. The position of the coil on the scalp can be held constant as verified by real time visual guidance. When evaluating higher cortical functions, the relationship between underlying cortical anatomy and the scalp stimulation site can be accurately assessed. Cortical motor output maps can be easily obtained for preoperative planning and decision making for mass lesions near rolandic cortex in patients. In conclusion, navigated TMS is a reliable alternative for localizing cortical functions and therefore may be a useful adjunct or in selected patients even a helpful alternative to other functional neuroimaging methods.