Abstract

Navigated transcranial magnetic stimulation (nTMS) is a widely used tool for motor cortex mapping. However, the full details of the activated cortical area during the mapping remain unknown due to the spread of the stimulating electric field (E-field). Computational tools, which combine the E-field with physiological responses, have potential for revealing the activated source area. We applied the minimum-norm estimate (MNE) method in a realistic head geometry to estimate the activated cortical area in nTMS motor mappings of the leg and hand muscles. We calculated the MNE also in a spherical head geometry to assess the effect of the head model on the MNE maps. Finally, we determined optimized coil placements based on the MNE map maxima and compared these placements with the initial hotspot placement. The MNE maps generally agreed well with the original motor maps: in the realistic head geometry, the distance from the MNE map maximum to the motor map center of gravity (CoG) was 8.8 ± 4.6 mm in the leg motor area and 6.6 ± 2.5 mm in the hand motor area. The head model did not have a significant effect on these distances; however, it had a significant effect on the distance between the MNE CoG and the motor map ( ). The optimized coil locations were < 1 cm from the initial hotspot in 7/10 subjects. Further research is required to determine the level of anatomical detail and the optimal mapping parameters required for robust and accurate localization.

Highlights

  • Transcranial magnetic stimulation (TMS) is a non-invasive method for stimulating the cerebral cortex [1]

  • The minimum-norm estimate (MNE) maps of the tibialis anterior (TA) and FDI muscles agreed with the original motor maps based on their distance to the motor map center of gravity (CoG) and hotspots

  • The head model had a significant effect on this distance only for the MNE CoG in the leg motor area

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Summary

INTRODUCTION

Transcranial magnetic stimulation (TMS) is a non-invasive method for stimulating the cerebral cortex [1]. Navigated TMS (nTMS) enables stimulation with high localization accuracy [7], [8], which is crucial for modern neurosurgery in pre-surgical mappings that aim to delineate the eloquent motor areas [9]–[13]. Recent studies implemented multi-scale computational modeling, combining individualized E-field calculations with morphologically realistic cortical neurons, to take into account activation mechanisms at the neuronal level [31]–[33]. Pitkänen et al applied the minimum-norm estimate (MNE) [37] in a spherical head geometry to take into account the effect of the E-field distribution on the nTMS-mapped motor areas [38]. We applied the MNE method in a realistic head geometry to assess the activated cortical area in nTMS motor maps of the leg and hand motor areas. To compare the MNE map maxima with the hotspots determined during the nTMS procedure, we calculated optimized coil placements by applying the computational approach presented by Gomez et al [39]

Subjects
Measurements
Motor-evoked potential analysis
Electric field modeling
Minimum-norm estimation
Coil placement optimization
Statistical methods
RESULTS
Minimum-norm estimations of the motor maps
Optimized coil placements
Findings
DISCUSSION
Full Text
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