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Evaluation of Changes in Preoperative Cortical Excitability by Navigated Transcranial Magnetic Stimulation in Patients With Brain Tumor.
Neville, Iuri Santana; Gomes Dos Santos, Alexandra; Almeida, Cesar Cimonari; Hayashi, Cintya Yukie; Solla, Davi Jorge Fontoura; Galhardoni, Ricardo; de Andrade, Daniel Ciampi; Brunoni, Andre Russowsky; Teixeira, Manoel Jacobsen; Paiva, Wellingson Silva.
Afiliación
  • Neville IS; Instituto do Cancer do Estado de São Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
  • Gomes Dos Santos A; LIM-62/Division of Neurosurgery, Department of Neurology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
  • Almeida CC; Service of Interdisciplinary Neuromodulation, Instituto de Psiquiatria do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
  • Hayashi CY; LIM-62/Division of Neurosurgery, Department of Neurology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
  • Solla DJF; LIM-62/Division of Neurosurgery, Department of Neurology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
  • Galhardoni R; Service of Interdisciplinary Neuromodulation, Instituto de Psiquiatria do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
  • de Andrade DC; LIM-62/Division of Neurosurgery, Department of Neurology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
  • Brunoni AR; Service of Interdisciplinary Neuromodulation, Instituto de Psiquiatria do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
  • Teixeira MJ; LIM-62/Division of Neurosurgery, Department of Neurology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
  • Paiva WS; LIM-62/Division of Neurosurgery, Department of Neurology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Front Neurol ; 11: 582262, 2020.
Article en En | MEDLINE | ID: mdl-33551949
Background: This prospective study aimed to evaluate the cortical excitability (CE) of patients with brain tumors surrounding or directly involving the corticospinal tract (CST) using navigated transcranial magnetic stimulation (nTMS). Methods: We recruited 40 patients with a single brain tumor surrounding or directly involving the CST as well as 82 age- and sex-matched healthy controls. The patients underwent standard nTMS and CE evaluations. Single and paired pulses were applied to the primary motor area (M1) of both affected and unaffected cerebral hemispheres 1 week before surgery. The CE parameters included resting motor threshold (RMT), motor evoked potential (MEP) ratio for 140 and 120% stimulus (MEP 140/120 ratio), short-interval intracortical inhibition (SICI), and intracortical facilitation (ICF). Motor outcome was evaluated on hospital discharge and on 30-day and 90-day postoperative follow-up. Results: In the affected hemispheres of patients, SICI and ICF were significantly higher than in the unaffected hemispheres (p=0.002 and p =0.009, respectively). The 140/120 MEP ratio of patients' unaffected hemispheres was lower than that in controls (p=0.001). Patients with glioblastomas (GBM) had a higher interhemispheric RMT ratio than patients with grade II and III gliomas ( p = 0.018). A weak correlation was observed among the RMT ratio and the preoperative motor score (R 2 = 0.118, p = 0.017) and the 90-day follow-up ( R 2 = 0.227, p = 0.016). Conclusion: Using preoperative nTMS, we found that brain hemispheres affected by tumors had abnormal CE and that patients with GBM had a distinct pattern of CE. These findings suggest that tumor biological behavior might play a role in CE changes.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Observational_studies Idioma: En Revista: Front Neurol Año: 2020 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Observational_studies Idioma: En Revista: Front Neurol Año: 2020 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Suiza