001     277799
005     20250423100224.0
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082 _ _ |a 610
100 1 _ |a Moser, Ismael
|0 0009-0008-5336-7240
|b 0
245 _ _ |a Analysis of Neuronal Excitability Profiles for Motor-Eloquent Brain Tumor Entities Using nTMS in 800 Patients.
260 _ _ |a Basel
|c 2025
|b MDPI
336 7 _ |a article
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520 _ _ |a Non-invasive motor mapping with navigated transcranial magnetic stimulation (nTMS) is an established diagnostic tool to identify spatial relationships between functional and tumor areas and to characterize motor excitability. Recently, nTMS has been used to analyze the impact of different brain tumor entities on motor excitability. However, entity-specific excitability patterns are not sufficiently validated yet.We retrospectively analyzed nTMS motor mapping data of 800 motor-eloquent brain tumor patients in this observational study. The motor excitability profile consisted of four nTMS parameters (resting motor threshold (RMT), cortical motor area, amplitude and latency) measured on both hemispheres. The relationship between motor excitability parameters and tumor entity, glioma subtype and motor status were assessed using multiple regressions analyses. Regression models included patient- and tumor-specific factors.Gliomas had more frequent pathologic RMT ratios (OR 1.76, 95%CI: 1.06-2.89, p = 0.030) compared to benign entities. In the subgroup of gliomas, pathologic RMT ratios were more associated with the isocitrate dehydrogenase (IDH)-wildtype status (OR 0.43, 95%CI: 0.23-0.79, p = 0.006) and less so with higher WHO grades (OR 1.61, 95%CI: 0.96-2.71, p = 0.074). This was true for both IDH-mutant astrocytomas (OR 0.43, 95%CI: 0.20-0.91, p = 0.027) and IDH-mutant oligodendrogliomas (OR 0.43, 95%CI: 0.20-0.93, p = 0.031). Motor area enlargement on the tumor hemisphere was more frequently observed in lower WHO-graded gliomas (OR 0.87, 95%CI: 0.78-0.97, p = 0.019). Interestingly, a larger cortical motor area was additionally found for oligodendrogliomas on the healthy hemisphere (OR 1.18, 95%CI: 1.01-1.39, p = 0.041). Motor deficits were related with higher RMT (OR 1.12, 95%CI: 1.05-1.21, p = 0.001), reduced amplitude (OR 0.78, 95%CI: 0.64-0.96, p = 0.019) and prolonged latency (OR 1.12, 95%CI: 1.02-1.24, p = 0.025) in the tumor hemisphere.Neuroplastic phenomena such as adjustment of the motor excitability level and an enlargement of the nTMS-positive motor area were more frequently observed in benign tumors and in IDH-mutated gliomas. Consequently, patients experienced motor deficits less often, suggesting a differentiated susceptibility to resection-related paresis. Future studies will analyze which stimulation paradigms are most effective in stimulating and optimizing neuroplasticity processes to improve the functional outcomes (and thus the quality of life) for patients.
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588 _ _ |a Dataset connected to CrossRef, PubMed, , Journals: pub.dzne.de
650 _ 7 |a brain tumor
|2 Other
650 _ 7 |a corticospinal tract
|2 Other
650 _ 7 |a glioma
|2 Other
650 _ 7 |a motor cortex
|2 Other
650 _ 7 |a motor evoked potential
|2 Other
650 _ 7 |a motor excitability
|2 Other
650 _ 7 |a navigated transcranial magnetic stimulation
|2 Other
650 _ 7 |a neuroplasticity
|2 Other
650 _ 7 |a resting motor threshold
|2 Other
700 1 _ |a Engelhardt, Melina
|0 0000-0002-2921-6329
|b 1
700 1 _ |a Grittner, Ulrike
|0 0000-0003-2595-0224
|b 2
700 1 _ |a Ferreira, Felipe Monte Santo Regino
|0 0000-0002-9289-2485
|b 3
700 1 _ |a Denker, Maren
|0 0009-0000-4868-8789
|b 4
700 1 _ |a Reinsch, Jennifer
|b 5
700 1 _ |a Fischer, Lisa
|b 6
700 1 _ |a Link, Tilman
|b 7
700 1 _ |a Heppner, Frank L
|0 P:(DE-2719)2812386
|b 8
|u dzne
700 1 _ |a Capper, David
|0 0000-0003-1945-497X
|b 9
700 1 _ |a Vajkoczy, Peter
|0 0000-0003-4350-392X
|b 10
700 1 _ |a Picht, Thomas
|0 0000-0002-8630-1466
|b 11
700 1 _ |a Rosenstock, Tizian
|0 0000-0002-0620-9118
|b 12
770 _ _ |a Surgical Advances in the Treatment of Gliomas: Preserving Function and Quality of Life
773 _ _ |a 10.3390/cancers17060935
|g Vol. 17, no. 6, p. 935 -
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