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Preoperative Repetitive Navigated TMS and Functional White Matter Tractography in a Bilingual Patient with a Brain Tumor in Wernike Area

Awake surgery and intraoperative neuromonitoring represent the gold standard for surgery of lesion located in language-eloquent areas of the dominant hemisphere, enabling the maximal safe resection while preserving language function. Nevertheless, this functional mapping is invasive; it can be execu...

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Autores principales: Baro, Valentina, Caliri, Samuel, Sartori, Luca, Facchini, Silvia, Guarrera, Brando, Zangrossi, Pietro, Anglani, Mariagiulia, Denaro, Luca, d’Avella, Domenico, Ferreri, Florinda, Landi, Andrea
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8145512/
https://www.ncbi.nlm.nih.gov/pubmed/33924964
http://dx.doi.org/10.3390/brainsci11050557
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author Baro, Valentina
Caliri, Samuel
Sartori, Luca
Facchini, Silvia
Guarrera, Brando
Zangrossi, Pietro
Anglani, Mariagiulia
Denaro, Luca
d’Avella, Domenico
Ferreri, Florinda
Landi, Andrea
author_facet Baro, Valentina
Caliri, Samuel
Sartori, Luca
Facchini, Silvia
Guarrera, Brando
Zangrossi, Pietro
Anglani, Mariagiulia
Denaro, Luca
d’Avella, Domenico
Ferreri, Florinda
Landi, Andrea
author_sort Baro, Valentina
collection PubMed
description Awake surgery and intraoperative neuromonitoring represent the gold standard for surgery of lesion located in language-eloquent areas of the dominant hemisphere, enabling the maximal safe resection while preserving language function. Nevertheless, this functional mapping is invasive; it can be executed only during surgery and in selected patients. Moreover, the number of neuro-oncological bilingual patients is constantly growing, and performing awake surgery in this group of patients can be difficult. In this scenario, the application of accurate, repeatable and non-invasive preoperative mapping procedures is needed, in order to define the anatomical distribution of both languages. Repetitive navigated transcranial magnetic stimulation (rnTMS) associated with functional subcortical fiber tracking (nTMS-based DTI-FT) represents a promising and comprehensive mapping tool to display language pathway and function reorganization in neurosurgical patients. Herein we report a case of a bilingual patient affected by brain tumor in the left temporal lobe, who underwent rnTMS mapping for both languages (Romanian and Italian), disclosing the true eloquence of the anterior part of the lesion in both tests. After surgery, language abilities were intact at follow-up in both languages. This case represents a preliminary application of nTMS-based DTI-FT in neurosurgery for brain tumor in eloquent areas in a bilingual patient.
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spelling pubmed-81455122021-05-26 Preoperative Repetitive Navigated TMS and Functional White Matter Tractography in a Bilingual Patient with a Brain Tumor in Wernike Area Baro, Valentina Caliri, Samuel Sartori, Luca Facchini, Silvia Guarrera, Brando Zangrossi, Pietro Anglani, Mariagiulia Denaro, Luca d’Avella, Domenico Ferreri, Florinda Landi, Andrea Brain Sci Case Report Awake surgery and intraoperative neuromonitoring represent the gold standard for surgery of lesion located in language-eloquent areas of the dominant hemisphere, enabling the maximal safe resection while preserving language function. Nevertheless, this functional mapping is invasive; it can be executed only during surgery and in selected patients. Moreover, the number of neuro-oncological bilingual patients is constantly growing, and performing awake surgery in this group of patients can be difficult. In this scenario, the application of accurate, repeatable and non-invasive preoperative mapping procedures is needed, in order to define the anatomical distribution of both languages. Repetitive navigated transcranial magnetic stimulation (rnTMS) associated with functional subcortical fiber tracking (nTMS-based DTI-FT) represents a promising and comprehensive mapping tool to display language pathway and function reorganization in neurosurgical patients. Herein we report a case of a bilingual patient affected by brain tumor in the left temporal lobe, who underwent rnTMS mapping for both languages (Romanian and Italian), disclosing the true eloquence of the anterior part of the lesion in both tests. After surgery, language abilities were intact at follow-up in both languages. This case represents a preliminary application of nTMS-based DTI-FT in neurosurgery for brain tumor in eloquent areas in a bilingual patient. MDPI 2021-04-28 /pmc/articles/PMC8145512/ /pubmed/33924964 http://dx.doi.org/10.3390/brainsci11050557 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Baro, Valentina
Caliri, Samuel
Sartori, Luca
Facchini, Silvia
Guarrera, Brando
Zangrossi, Pietro
Anglani, Mariagiulia
Denaro, Luca
d’Avella, Domenico
Ferreri, Florinda
Landi, Andrea
Preoperative Repetitive Navigated TMS and Functional White Matter Tractography in a Bilingual Patient with a Brain Tumor in Wernike Area
title Preoperative Repetitive Navigated TMS and Functional White Matter Tractography in a Bilingual Patient with a Brain Tumor in Wernike Area
title_full Preoperative Repetitive Navigated TMS and Functional White Matter Tractography in a Bilingual Patient with a Brain Tumor in Wernike Area
title_fullStr Preoperative Repetitive Navigated TMS and Functional White Matter Tractography in a Bilingual Patient with a Brain Tumor in Wernike Area
title_full_unstemmed Preoperative Repetitive Navigated TMS and Functional White Matter Tractography in a Bilingual Patient with a Brain Tumor in Wernike Area
title_short Preoperative Repetitive Navigated TMS and Functional White Matter Tractography in a Bilingual Patient with a Brain Tumor in Wernike Area
title_sort preoperative repetitive navigated tms and functional white matter tractography in a bilingual patient with a brain tumor in wernike area
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8145512/
https://www.ncbi.nlm.nih.gov/pubmed/33924964
http://dx.doi.org/10.3390/brainsci11050557
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