TAMURA Manabu
   Department   Graduate School of Medical Science, Graduate School of Medical Science
   Position   Associate Professor
Article types Original article
Language English
Peer review Peer reviewed
Title Effect of resting motor threshold availability on preoperative motor cortex localization using navigated-TMS in glioma surgery.
Journal Formal name：Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology
Abbreviation：Clin Neurophysiol
ISSN code：18728952/13882457
Domestic / ForeginForegin
Volume, Issue, Page 181,pp.2111429
Author and coauthor Buntou Ro, Manabu Tamura, Atsushi Kuwano, Tomokazu Takakura, Sachiko Kodera, Akimasa Hirata, Takakazu Kawamata, Ken Masamune, Yoshihiro Muragaki
Publication date 2025/11
Summary 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