scholarly journals The role of neurophysiological assessments during the combined treatment of patients with malignant brain tumors

2021 ◽  
Vol 20 (4) ◽  
pp. 38-45
Author(s):  
A. V. Kartashev ◽  
N. V. Il’in ◽  
E. G. Zaitseva ◽  
V. B. Voitenkov  ◽  
Ju. N. Vinogradova
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Brain Tumors ◽  
Magnetic Stimulation ◽  
Radiation Treatment ◽  
Combined Treatment ◽  
Brain Diseases ◽  
Dynamic Monitoring ◽  
Conduction Time ◽  
Malignant Brain Tumors ◽  
Wide Range

Introduction. Dynamic monitoring and evaluation of the results of therapy of patients with malignant brain diseases is a complex and urgent problem in modern medicine. The aim of the study was to assess the reliability of the transcranial magnetic stimulation technique as a tool for neurophysiological monitoring in patients with malignant brain tumors. Material and methods. Two groups of patients were formed: adults with large focal solitary lesions of the central nervous system (glioma) (n=20), who underwent radiotherapy, and a control comparison group (n=16). All patients underwent diagnostic transcranial magnetic stimulation before and after treatment. Results. In the main group the application of transcranial magnetic stimulation in dynamics allowed to reveal reliable improvement of conduction along the central motor pathways (increase in amplitude of the evoked motor response). The obtained data of neurophysiological examination correlated with clinical improvement in the patient group. Discussion. Some parameters of the motor evoked response (MEP) changed reliably, as after the radiation treatment performed. Obtained changes (amplitude of MEP and, especially, its threshold) to the greatest extent reflect functional state of cortical motoneurons, as well as their anatomical preservation in case of organic changes. Before therapy in all cases there was a reliable tendency to a smaller amplitude and a higher threshold of cortical MEPs, which reflects a decrease in the functional activity of motor cortex neurons; a slower central motor conduction time also draws attention. These changes had a universal character and were registered in all patients. Conclusion. Diagnostic transcranial magnetic stimulation, taking into account age limitations inherent to it as a technique, is a valuable additional neurophysiological technique. It is safe, inexpensive and does not require expensive consumables, and is applicable to a wide range of diseases.

Associations between clinical outcome and tractography based on navigated transcranial magnetic stimulation in patients with language-eloquent brain lesions

2020 ◽  
Vol 132 (4) ◽  
pp. 1033-1042 ◽  
Author(s):  
Nico Sollmann ◽  
Alessia Fratini ◽  
Haosu Zhang ◽  
Claus Zimmer ◽  
Bernhard Meyer ◽  
...  
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Brain Tumors ◽  
Risk Stratification ◽  
Magnetic Stimulation ◽  
Diffusion Tensor ◽  
Tumor Resection ◽  
Navigated Transcranial Magnetic Stimulation ◽  
Language Mapping ◽  
Significant Difference ◽  
Related Pathway

OBJECTIVENavigated transcranial magnetic stimulation (nTMS) in combination with diffusion tensor imaging fiber tracking (DTI FT) is increasingly used to locate subcortical language-related pathways. The aim of this study was to establish nTMS-based DTI FT for preoperative risk stratification by evaluating associations between lesion-to-tract distances (LTDs) and aphasia and by determining a cut-off LTD value to prevent surgery-related permanent aphasia.METHODSFifty patients with left-hemispheric, language-eloquent brain tumors underwent preoperative nTMS language mapping and nTMS-based DTI FT, followed by tumor resection. nTMS-based DTI FT was performed with a predefined fractional anisotropy (FA) of 0.10, 0.15, 50% of the individual FA threshold (FAT), and 75% FAT (minimum fiber length [FL]: 100 mm). The arcuate fascicle (AF), superior longitudinal fascicle (SLF), inferior longitudinal fascicle (ILF), uncinate fascicle (UC), and frontooccipital fascicle (FoF) were identified in nTMS-based tractography, and minimum LTDs were measured between the lesion and the AF and between the lesion and the closest other subcortical language-related pathway (SLF, ILF, UC, or FoF). LTDs were then associated with the level of aphasia (no/transient or permanent surgery-related aphasia, according to follow-up examinations).RESULTSA significant difference in LTDs was observed between patients with no or only surgery-related transient impairment and those who developed surgery-related permanent aphasia with regard to the AF (FA = 0.10, p = 0.0321; FA = 0.15, p = 0.0143; FA = 50% FAT, p = 0.0106) as well as the closest other subcortical language-related pathway (FA = 0.10, p = 0.0182; FA = 0.15, p = 0.0200; FA = 50% FAT, p = 0.0077). Patients with surgery-related permanent aphasia showed the lowest LTDs in relation to these tracts. Thus, LTDs of ≥ 8 mm (AF) and ≥ 11 mm (SLF, ILF, UC, or FoF) were determined as cut-off values for surgery-related permanent aphasia.CONCLUSIONSnTMS-based DTI FT of subcortical language-related pathways seems suitable for risk stratification and prediction in patients suffering from language-eloquent brain tumors. Thus, the current role of nTMS-based DTI FT might be expanded, going beyond the level of being a mere tool for surgical planning and resection guidance.

LOCAL HYPERTHERMIA IN TREATMENT FOR MALIGNANT BRAIN TUMORS

2018 ◽  
Vol 64 (1) ◽  
pp. 54-61
Author(s):  
A. Ryabova ◽  
O. Gribova ◽  
V. Novikov ◽  
E. Choinzonov ◽  
Zh. Starceva ◽  
...  
Keyword(s):  
Experimental Data ◽  
Radiation Therapy ◽  
Brain Tumors ◽  
Tumor Cells ◽  
Combined Treatment ◽  
Complex Treatment ◽  
Local Hyperthermia ◽  
Malignant Brain Tumors ◽  
Sensitizing Effect ◽  
Methods Of Treatment

Unsatisfactory results of complex treatment for malignant brain tumors stimulate search of new effective methods of treatment. Radiation therapy is an integral part of the combined treatment but often does not influence lethally on resistant tumor cells. Thereby in recent decades there has been an active search for different modifiers, which can increase the sensitivity of tumors to chemotherapy and radiotherapy. One of the universal sensitizers is the local hyperthermia. Experimental data showed that the effect of high temperatures had both a direct damaging effect on tumor cells and a sensitizing effect. The literature review given in the article provides an overview of the existing methods of the local hyperthermia for brain tumors treatment.

scholarly journals Motor disability in patients with multiple sclerosis: transcranial magnetic stimulation study

2020 ◽  
Vol 56 (1) ◽  
Author(s):  
Anssam Bassem Mohy ◽  
Aqeel Kareem Hatem ◽  
Hussein Ghani Kadoori ◽  
Farqad Bader Hamdan
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Lower Limb ◽  
Magnetic Stimulation ◽  
Motor Evoked Potential ◽  
Invasive Procedure ◽  
Single Pulse ◽  
Lower Limbs ◽  
Control Group ◽  
Conduction Time ◽  
Motor Disability

Abstract Background Transcranial magnetic stimulation (TMS) is a non-invasive procedure used in a small targeted region of the brain via electromagnetic induction and used diagnostically to measure the connection between the central nervous system (CNS) and skeletal muscle to evaluate the damage that occurs in MS. Objectives The study aims to investigate whether single-pulse TMS measures differ between patients with MS and healthy controls and to consider if these measures are associated with clinical disability. Patients and methods Single-pulse TMS was performed in 26 patients with MS who hand an Expanded Disability Status Scale (EDSS) score between 0 and 9.5 and in 26 normal subjects. Different TMS parameters from upper and lower limbs were investigated. Results TMS disclosed no difference in all MEP parameters between the right and left side of the upper and lower limbs in patients with MS and controls. In all patients, TMS parameters were different from the control group. Upper limb central motor conduction time (CMCT) was prolonged in MS patients with pyramidal signs. Upper and lower limb CMCT and CMCT-f wave (CMCT-f) were prolonged in patients with ataxia. Moreover, CMCT and CMCT-f were prolonged in MS patients with EDSS of 5–9.5 as compared to those with a score of 0–4.5. EDSS correlated with upper and lower limb cortical latency (CL), CMCT, and CMCT-f whereas motor evoked potential (MEP) amplitude not. Conclusion TMS yields objective data to evaluate clinical disability and its parameters correlated well with EDSS.

scholarly journals First United Kingdom Experience of Navigated Transcranial Magnetic Stimulation in Preoperative Mapping of Brain Tumors

2019 ◽  
Vol 122 ◽  
pp. e1578-e1587 ◽  
Author(s):  
Josephine Jung ◽  
José-Pedro Lavrador ◽  
Sabina Patel ◽  
Anastasios Giamouriadis ◽  
Jordan Lam ◽  
...  
Keyword(s):  
United Kingdom ◽  
Transcranial Magnetic Stimulation ◽  
Brain Tumors ◽  
Magnetic Stimulation ◽  
Navigated Transcranial Magnetic Stimulation ◽  
Preoperative Mapping

scholarly journals Clinical, Neurophysiological, and MRI Markers of Fampridine Responsiveness in Multiple Sclerosis—An Explorative Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Sepehr Mamoei ◽  
Henrik Boye Jensen ◽  
Andreas Kristian Pedersen ◽  
Mikkel Karl Emil Nygaard ◽  
Simon Fristed Eskildsen ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Longitudinal Study ◽  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Motor Evoked Potentials ◽  
Step Test ◽  
Conduction Time ◽  
Lesion Load ◽  
Clinical Trial Registration ◽  
Peripheral Motor

Objective: Persons with multiple sclerosis (PwMS), already established as responders or non-responders to Fampridine treatment, were compared in terms of disability measures, physical and cognitive performance tests, neurophysiology, and magnetic resonance imaging (MRI) outcomes in a 1-year explorative longitudinal study.Materials and Methods: Data from a 1-year longitudinal study were analyzed. Examinations consisted of the timed 25-foot walk test (T25FW), six spot step test (SSST), nine-hole peg test (9-HPT), five times sit-to-stand test (5-STS), symbol digit modalities test (SDMT), transcranial magnetic stimulation (TMS) elicited motor evoked potentials (MEP) examining central motor conduction times (CMCT), peripheral motor conduction times (PMCT) and their amplitudes, electroneuronography (ENG) of the lower extremities, and brain structural MRI measures.Results: Forty-one responders and eight non-responders to Fampridine treatment were examined. There were no intergroup differences except for the PMCT, where non-responders had prolonged conduction times compared to responders to Fampridine. Six spot step test was associated with CMCT throughout the study. After 1 year, CMCT was further prolonged and cortical MEP amplitudes decreased in both groups, while PMCT and ENG did not change. Throughout the study, CMCT was associated with the expanded disability status scale (EDSS) and 12-item multiple sclerosis walking scale (MSWS-12), while SDMT was associated with number of T2-weighted lesions, lesion load, and lesion load normalized to brain volume.Conclusions: Peripheral motor conduction time is prolonged in non-responders to Fampridine when compared to responders. Transcranial magnetic stimulation-elicited MEPs and SDMT can be used as markers of disability progression and lesion activity visualized by MRI, respectively.Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT03401307.

Transcranial magnetic stimulation in neurorehabilitation: experience and prospects

2021 ◽  
pp. 7-17
Author(s):  
Vladislav Borisovich Voitenkov ◽  
J. Málly ◽  
I. V. Cherkashina ◽  
N. V. Skripchenko . ◽  
E. V. Ekusheva ◽  
...  
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Low Cost ◽  
Motor Pathway ◽  
Rehabilitation Process ◽  
Motor Pathways ◽  
Wide Range ◽  
Central Inhibition ◽  
Adults And Children ◽  
Therapy And Diagnosis

Diagnostic transcranial magnetic stimulation (TMS) is a valuable neurophysiological technique. The use of TMS has fundamentally changed the therapy and diagnosis of nervous diseases, introducing the possibility of direct assessment of conduction along the motor pathway in the central region, neuroplasticity, the ratio of central inhibition and excitation, and the effect on neuroplasticity and neurogenesis. The technique is safe, has a low cost and there is no need to purchase expensive consumables, it is applicable for a wide range of diseases in both adult and pediatric practice. The issues of the TMS use in CVA, depression, cerebral palsy and neurodegenerative diseases (amyotrophic lateral sclerosis, parkinsonism) have been studied to the greatest extent. When carrying out TMS in children, it should be borne in mind that signs of incomplete myelination of the motor pathways, which are normally observed, may look like pathological changes (demyelination or axonal disorders). The basic principles of TMS in both adults and children have been established and known, and the age norms have been determined, which makes it possible to widely implement this technique in applied neurophysiological practice. In the rehabilitation process, TMS can be used as a tool for personalizing and monitoring the effectiveness of rehabilitation treatment.

Interhemispheric Connectivity in Idiopathic Cervical Dystonia and Spinocerebellar Ataxias: A Transcranial Magnetic Stimulation Study

2020 ◽  
pp. 155005942095748 ◽  
Author(s):  
Tommaso Bocci ◽  
Davide Baloscio ◽  
Roberta Ferrucci ◽  
Lucia Briscese ◽  
Alberto Priori ◽  
...  
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Cervical Dystonia ◽  
Magnetic Stimulation ◽  
Silent Period ◽  
Cortical Inhibition ◽  
Common Disease ◽  
Conduction Time ◽  
Mutational Load ◽  
Spinocerebellar Ataxias ◽  
Interhemispheric Communication

Background and Rationale Hyperkinetic movement disorders represent a heterogeneous group of diseases, different from a genetic and clinical perspective. In the past, neurophysiological approaches provided different, sometimes contradictory findings, pointing to an impaired cortical inhibition as a common electrophysiological marker. Our aim was to evaluate changes in interhemispheric communication in patients with idiopathic cervical dystonia (ICD) and spinocerebellar ataxias (SCAs). Materials and Methods Eleven patients with ICD, 7 with genetically confirmed SCA2 or SCA3, and 10 healthy volunteers were enrolled. The onset latency and duration of the ipsilateral silent period (iSPOL and iSPD, respectively), as well as the so-called transcallosal conduction time (TCT), were then recorded from the abductor pollicis brevis of the right side using an 8-shaped focal coil with wing diameters of 70 mm; all these parameters were evaluated and compared among groups. In SCAs, changes in neurophysiological measures were also correlated to the mutational load. Results iSPD was significantly shorter in patients with SCA2 and SCA3, when compared both to control and ICD ( P < .0001); iSPOL and TCT were prolonged in SCAs patients ( P < .001). Changes in iSPD, iSPOL, and TCT in SCAs are significantly correlated with the mutational load ( P = .01, P = .02, and P = .002, respectively). Discussion This is the first study to assess changes in interhemispheric communication in patients with SCAs and ICD, using a transcranial magnetic stimulation protocol. Together with previous data in Huntington’s disease, we suggest that these changes may underlie, at least in part, a common disease mechanism of polyglutamine disorders.

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