Motor Eloquent Navigated Transcranial Magnetic Stimulation for Radiosurgery Planning

Summary

With this project, the study group wants to investigate whether a postoperative navigated transcranial magnetic stimulation (nTMS) motor map can improve stereotactic radiosurgery (SRS) planning in patients who underwent resection for a brain metastasis near the primary motor cortex. Specifically, the map could allow for more precise location of motor eloquent tissue, thereby minimizing the radiation dose on these areas while preserving high radiation dose on target tissue (i.e. tumor cells).

Eligibility

Inclusion Criteria:

1. Informed consent
2. Age ≥ 18 years
3. Cerebral metastasis within or adjacent to the primary motor cortex (≤10 mm)
4. Resection of tumor
5. Eligible for and planned to undergo postresection radiosurgery at Inselspital Bern

Exclusion Criteria:

1. Contraindication to TMS (e.g. Cochlear Implant, other metallic or electrical implants, excluding teeth and post craniotomy, Meniere's disease, pacemaker, deep brain stimulation electrodes, refractory convulsion, symptomatic tinnitus, depression diagnosed by a specialist, psychosis)
2. Prior cerebral radiation therapy within the affected precentral gyrus/affecting the planned SRS plan
3. Planned whole brain radiotherapy
4. Second lesion within 2 cm ipsilateral in the primary motor cortex
5. Infection or difficulties in wound healing within the last two weeks prior inclusion
6. Pregnancy

Conditions2

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