Universität zu Köln

Lucas, Carolin Weiss, Tursunova, Irada, Neuschmelting, Volker, Nettekoven, Charlotte, Oros-Peusquens, Ana-Maria, Stoffels, Gabriele ORCID: 0000-0001-7114-1941, Faymonville, Andrea Maria, Jon, Shah N., Langen, Karl Josef, Lockau, Hannah, Goldbrunner, Roland and Grefkes, Christian ORCID: 0000-0002-1656-720X (2017). Functional MRI vs. navigated TMS to optimize M1 seed volume delineation for DTI tractography. A prospective study in patients with brain tumours adjacent to the corticospinal tract. NeuroImage-Clin., 13. S. 297 - 310. OXFORD: ELSEVIER SCI LTD. ISSN 2213-1582

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Abstract

Background: DTI-based tractography is an increasingly important tool for planning brain surgery in patients suffering from brain tumours. However, there is an ongoing debate which tracking approaches yield the most valid results. Especially the use of functional localizer data such as navigated transcranial magnetic stimulation (nTMS) or functional magnetic resonance imaging (fMRI) seem to improve fibre tracking data in conditions where anatomical landmarks are less informative due to tumour-induced distortions of the gyral anatomy. We here compared which of the two localizer techniques yields more plausible results with respect to mapping different functional portions of the corticospinal tract (CST) in brain tumour patients. Methods: The CSTs of 18 patients with intracranial tumours in the vicinity of the primary motor area (M1) were investigated by means of deterministic DTI. The core zone of the tumour-adjacent hand, foot and/or tongue M1 representation served as cortical regions of interest (ROIs). M1 core zones were defined by both the nTMS hotspots and the fMRI local activation maxima. In addition, for all patients, a subcortical ROI at the level of the inferior anterior pons was implemented into the tracking algorithm in order to improve the anatomical specificity of CST reconstructions. As intra-individual control, we additionally tracked the CST of the hand motor region of the unaffected, i.e., non-lesional hemisphere, again comparing fMRI and nTMS M1 seeds. The plausibility of the fMRI-ROI- vs. nTMS-ROI-based fibre trajectories was assessed by a-priori defined anatomical criteria. Moreover, the anatomical relationship of different fibre courses was compared regarding their distribution in the anterior-posterior direction as well as their location within the posterior limb of the internal capsule (PLIC). Results: Overall, higher plausibility rates were observed for the use of nTMS-as compared to fMRI-defined cortical ROIs (p < 0.05) in tumour vicinity. On the non-lesional hemisphere, however, equally good plausibility rates (100%) were observed for both localizer techniques. fMRI-originated fibres generally followed a more posterior course relative to the nTMS-based tracts (p < 0.01) in both the lesional and non-lesional hemisphere. Conclusion: NTMS achieved better tracking results than fMRI in conditions when the cortical tract origin (M1) was located in close vicinity to a brain tumour, probably influencing neurovascular coupling. Hence, especially in situations with altered BOLD signal physiology, nTMS seems to be the method of choice in order to identify seed regions for CST mapping in patients. (C) 2016 The Authors. Published by Elsevier Inc.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Lucas, Carolin Weiss UNSPECIFIED UNSPECIFIED UNSPECIFIED Tursunova, Irada UNSPECIFIED UNSPECIFIED UNSPECIFIED Neuschmelting, Volker UNSPECIFIED UNSPECIFIED UNSPECIFIED Nettekoven, Charlotte UNSPECIFIED UNSPECIFIED UNSPECIFIED Oros-Peusquens, Ana-Maria UNSPECIFIED UNSPECIFIED UNSPECIFIED Stoffels, Gabriele UNSPECIFIED orcid.org/0000-0001-7114-1941 UNSPECIFIED Faymonville, Andrea Maria UNSPECIFIED UNSPECIFIED UNSPECIFIED Jon, Shah N. UNSPECIFIED UNSPECIFIED UNSPECIFIED Langen, Karl Josef UNSPECIFIED UNSPECIFIED UNSPECIFIED Lockau, Hannah UNSPECIFIED UNSPECIFIED UNSPECIFIED Goldbrunner, Roland UNSPECIFIED UNSPECIFIED UNSPECIFIED Grefkes, Christian UNSPECIFIED orcid.org/0000-0002-1656-720X UNSPECIFIED
URN:	urn:nbn:de:hbz:38-246377
DOI:	10.1016/j.nicl.2016.11.022
Journal or Publication Title:	NeuroImage-Clin.
Volume:	13
Page Range:	S. 297 - 310
Date:	2017
Publisher:	ELSEVIER SCI LTD
Place of Publication:	OXFORD
ISSN:	2213-1582
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language TRANSCRANIAL MAGNETIC STIMULATION; SUBCORTICAL ELECTRICAL-STIMULATION; IMAGING-BASED TRACTOGRAPHY; FALSE DISCOVERY RATE; PRIMARY MOTOR CORTEX; LOW-GRADE GLIOMAS; DIFFUSION-TENSOR; WHITE-MATTER; FIBER TRACKING; SOMATOTOPIC ORGANIZATION Multiple languages Neuroimaging Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/24637