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ムラガキ ヨシヒロ
MURAGAKI Yoshihiro
村垣 善浩 所属 医学部 医学科（東京女子医科大学病院） 職種 客員教授 |
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| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読あり |
| 表題 | Effect of resting motor threshold availability on preoperative motor cortex localization using navigated-TMS in glioma surgery. |
| 掲載誌名 | 正式名：Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology 略 称：Clin Neurophysiol ISSNコード：18728952/13882457 |
| 掲載区分 | 国外 |
| 巻・号・頁 | 181,pp.2111429 |
| 著者・共著者 | Buntou Ro, Manabu Tamura, Atsushi Kuwano, Tomokazu Takakura, Sachiko Kodera, Akimasa Hirata, Takakazu Kawamata, Ken Masamune, Yoshihiro Muragaki |
| 発行年月 | 2025/11 |
| 概要 | OBJECTIVE:To assess the concordance between preoperative motor cortex mapping using navigated transcranial magnetic stimulation (nTMS) and intraoperative direct electrical stimulation (DES), and to determine whether the ability to obtain the resting motor threshold (RMT) affects mapping accuracy.METHODS:Seventeen patients with motor or premotor cortical gliomas underwent preoperative nTMS and intraoperative DES. Motor mapping was performed using the RMT or, if unobtainable, the active motor threshold (AMT). Concordance between nTMS and DES was analyzed using Fisher's exact test.RESULTS:Spatial concordance between nTMS and DES was observed in 9 of 12 patients (75 %) with measurable RMT. None of the five AMT-only cases demonstrated concordance. The difference in concordance rates between RMT and AMT-only cases was statistically significant (p = 0.026). Representative cases illustrate the relationship between RMT availability and mapping accuracy.CONCLUSIONS:Preoperative nTMS mapping showed high concordance with DES when the RMT was obtainable. The lack of an RMT may predict reduced intraoperative mapping reliability.SIGNIFICANCE:RMT preoperative assessment can guide surgical planning, including the need for subcortical mapping or adjusted resection margins. These findings highlight the utility of nTMS for motor localization and emphasize the value of the RMT for predicting intraoperative mapping success. |
| DOI | 10.1016/j.clinph.2025.2111429 |
| PMID | 41232483 |