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  • Low grade gliomas in motor area and cortical displacement

    Final Number:

    Wellingson S. Paiva MD PhD; Erich Talamoni Fonoff PhD; Iuri S Neville MD; Andre R Brunoni MD, PhD; Eberval G. Figueiredo MD, PhD; Manoel Jacobsen Teixeira

    Study Design:

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2014 Annual Meeting

    Introduction: Using mapping of the motor cortex by transcranial magnetic stimulation navigated to assess cortical plasticity and displacement motor area in patients with low-grade gliomas .

    Methods: In this prospective study, six patients with low-grade gliomas in or near the precentral gyrus underwent TMS mapping, and their motor responses were correlated to locations in the cortex around the lesion, generating a functional map overlaid on three-dimensional magnetic resonance imaging (MRI) scans of the brain. To determine anatomical changes, we compared TMS mapping in each hemisphere, comparing side with tumor versus contralateral normal side

    Results: Referring to the distortion of the anatomy of the motor area , we have identified differences comparing the normal side of the patients as control ( p = 0.001 ). When we analyze a comparative areas of transcranial magnetic stimulation in the side with the tumor with the normal hemisphere, we identified a smaller mapped area in the cortex with anatomical deformity compared to the area of the normal cortex ( p = 0.01 )

    Conclusions: Low grade gliomas in motor area result in important cortical displacement

    Patient Care: understanding the cortical changes in patients with gliomas may prevent postoperative neurological sequelae

    Learning Objectives: 1. studying the physiology of the motor cortex and aspects of cortical plasticity 2. To describe aspects of neuronal recruitment in low-grade gliomas surgery

    References: 1. Kim J, Horwitz B. Investigating the neural basis for fMRI-based functional connectivity in a blocked design: application to interregional correlations and psycho-physiological interactions. Magn Reson Imaging. 2008;26(5):583–593. 2. Dolbakyan EE, Merzhanova GKh. Organization of neural networks in the neocortex. Neurosci Behav Physiol. 2003;33(6):555–565. 3. Säisänen L, Pirinen E, Teitti S, et al. Factors influencing cortical silent period: optimized stimulus location, intensity and muscle contraction. J Neurosci Methods. 2008;169(1):231–238. 4. Herwig U, Schönfeldt-Lecuona C, Wunderlich AP, et al. The navigation of transcranial magnetic stimulation. Psychiatry Res. 2001;108(2):123–131

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