Significance of diagnostic transcranial magnetic stimulation during radiotherapy

Abstract

Background. Transcranial magnetic stimulation is a non-invasive, painless method that stimulates the cerebral cortex using short magnetic pulses. The information obtained as a result of the research can be further used for an objective assessment of the therapy.

Aim. Evaluation the reliability of transcranial magnetic stimulation technique as a neurophysiological monitoring tool in patients with malignant brain tumors.

Material and methods. There were two groups as a study objects: patients with large-focal solitary lesions of the central nervous system (glioma) who underwent radiotherapy (n=20), median age 49.5±5.3 (39; 60) years, and a comparison group of neurologically healthy individuals (n=16), median age 48.5±6.3 (43.0; 58.8) years. There were no statistically significant age differences between the studied groups. All patients underwent diagnostic transcranial magnetic stimulation before and after therapy. The Mann–Whitney test was used to make comparisons between the two groups. A p value <0.05 was considered statistically significant.

Results. During transcranial magnetic stimulation in patients with malignant brain neoplasms, signs of impaired conduction along the central motor pathways were recorded in 50% of cases, and in total, signs of impaired conduction of all degrees of severity along the central motor pathway were detected in 90% of cases. Carrying out diagnostic transcranial magnetic stimulation according to a single-pulse protocol makes it possible to predict the further course of the recovery period. The use of transcranial magnetic stimulation in dynamics revealed an improvement in conduction along the central motor pathways in patients with malignant brain neoplasms. The obtained statistically significant differences allow us to conclude that transcranial magnetic stimulation can be used for an objective assessment of the state of the motor pathways in patients with neurooncological diseases.

Conclusion. Diagnostic transcranial magnetic stimulation is applicable in large-focal solitary lesions of the central nervous system, since it allows assessing the state of the motor pathways and the functional activity of the brain at different stages of this condition.

Keywords

radiotherapy / transcranial magnetic stimulation / brain tumors / magnetic coil / neurodegenerative diseases / glioma / evoked motor responses

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