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Protocol for mapping of the supplementary motor area using repetitive navigated transcranial magnetic stimulation

BACKGROUND: Damage to the supplementary motor area (SMA) can lead to impairments of motor and language function. A detailed preoperative mapping of functional boarders of the SMA could therefore aid preoperative diagnostics in these patients. OBJECTIVE: The aim of this study was the development of a...

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Autores principales: Engelhardt, Melina, Kern, Giulia, Karhu, Jari, Picht, Thomas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10272366/
https://www.ncbi.nlm.nih.gov/pubmed/37332876
http://dx.doi.org/10.3389/fnins.2023.1185483
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author Engelhardt, Melina
Kern, Giulia
Karhu, Jari
Picht, Thomas
author_facet Engelhardt, Melina
Kern, Giulia
Karhu, Jari
Picht, Thomas
author_sort Engelhardt, Melina
collection PubMed
description BACKGROUND: Damage to the supplementary motor area (SMA) can lead to impairments of motor and language function. A detailed preoperative mapping of functional boarders of the SMA could therefore aid preoperative diagnostics in these patients. OBJECTIVE: The aim of this study was the development of a repetitive nTMS protocol for non-invasive functional mapping of the SMA while assuring effects are caused by SMA rather than M1 activation. METHODS: The SMA in the dominant hemisphere of 12 healthy subjects (28.2 ± 7.7 years, 6 females) was mapped using repetitive nTMS at 20 Hz (120% RMT), while subjects performed a finger tapping task. Reductions in finger taps were classified in three error categories (≤15% = no errors, 15–30% = mild, >30% significant). The location and category of induced errors was marked in each subject’s individual MRI. Effects of SMA stimulation were then directly compared to effects of M1 stimulation in four different tasks (finger tapping, writing, line tracing, targeting circles). RESULTS: Mapping of the SMA was possible for all subjects, yet effect sizes varied. Stimulation of the SMA led to a significant reduction of finger taps compared to baseline (BL: 45taps, SMA: 35.5taps; p < 0.01). Line tracing, writing and targeting of circles was less accurate during SMA compared to M1 stimulation. CONCLUSION: Mapping of the SMA using repetitive nTMS is feasible. While errors induced in the SMA are not entirely independent of M1, disruption of the SMA induces functionally distinct errors. These error maps can aid preoperative diagnostics in patients with SMA related lesions.
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spelling pubmed-102723662023-06-17 Protocol for mapping of the supplementary motor area using repetitive navigated transcranial magnetic stimulation Engelhardt, Melina Kern, Giulia Karhu, Jari Picht, Thomas Front Neurosci Neuroscience BACKGROUND: Damage to the supplementary motor area (SMA) can lead to impairments of motor and language function. A detailed preoperative mapping of functional boarders of the SMA could therefore aid preoperative diagnostics in these patients. OBJECTIVE: The aim of this study was the development of a repetitive nTMS protocol for non-invasive functional mapping of the SMA while assuring effects are caused by SMA rather than M1 activation. METHODS: The SMA in the dominant hemisphere of 12 healthy subjects (28.2 ± 7.7 years, 6 females) was mapped using repetitive nTMS at 20 Hz (120% RMT), while subjects performed a finger tapping task. Reductions in finger taps were classified in three error categories (≤15% = no errors, 15–30% = mild, >30% significant). The location and category of induced errors was marked in each subject’s individual MRI. Effects of SMA stimulation were then directly compared to effects of M1 stimulation in four different tasks (finger tapping, writing, line tracing, targeting circles). RESULTS: Mapping of the SMA was possible for all subjects, yet effect sizes varied. Stimulation of the SMA led to a significant reduction of finger taps compared to baseline (BL: 45taps, SMA: 35.5taps; p < 0.01). Line tracing, writing and targeting of circles was less accurate during SMA compared to M1 stimulation. CONCLUSION: Mapping of the SMA using repetitive nTMS is feasible. While errors induced in the SMA are not entirely independent of M1, disruption of the SMA induces functionally distinct errors. These error maps can aid preoperative diagnostics in patients with SMA related lesions. Frontiers Media S.A. 2023-06-02 /pmc/articles/PMC10272366/ /pubmed/37332876 http://dx.doi.org/10.3389/fnins.2023.1185483 Text en Copyright © 2023 Engelhardt, Kern, Karhu and Picht. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neuroscience
Engelhardt, Melina
Kern, Giulia
Karhu, Jari
Picht, Thomas
Protocol for mapping of the supplementary motor area using repetitive navigated transcranial magnetic stimulation
title Protocol for mapping of the supplementary motor area using repetitive navigated transcranial magnetic stimulation
title_full Protocol for mapping of the supplementary motor area using repetitive navigated transcranial magnetic stimulation
title_fullStr Protocol for mapping of the supplementary motor area using repetitive navigated transcranial magnetic stimulation
title_full_unstemmed Protocol for mapping of the supplementary motor area using repetitive navigated transcranial magnetic stimulation
title_short Protocol for mapping of the supplementary motor area using repetitive navigated transcranial magnetic stimulation
title_sort protocol for mapping of the supplementary motor area using repetitive navigated transcranial magnetic stimulation
topic Neuroscience
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10272366/
https://www.ncbi.nlm.nih.gov/pubmed/37332876
http://dx.doi.org/10.3389/fnins.2023.1185483
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