Journal Article

Intraoperative integration of nTMS, CCEPs and DCS for language. A glance to the next future?

Grippo, Antonello, Bonaudo, Camilla, Pieropan, Edoardo, Fedi, Francesca, Della Puppa, Alessandro, Baldanzi, Fabrizio, Carrai, Riccardo, Visocchi, Eleonora, Battista, Francesca

2025

Overview

Background Direct-Cortical-Stimulation (DCS), Navigated-Transcranial Magnetic-Stimulation (nTMS), Cortico-Cortical-Evoked-Potentials (CCEPs) can be synergically used to monitor Language-network. Methods We illustrate a case of multimodal approach for removal of one left fronto-temporo-insular Low-Grade-Glioma. Results A 32-years-old female patient was operated in awake surgery (using D080-picture-naming-test). We documented a matching correspondence among frontal nTMS + spots, Penfield DCS, and CCEPs stimulation strip. The same was found in the temporal area among nTMS, DCS, and CCEPs recording strip. [Average distance among nTMS, DCS and CCEPs spots = 5.10 mm, STD = 1.08 mm. Se, PPV and Precision:100%]. Conclusions We documented the potential utility of matching synergic technologies to preserve language.

• Publisher: Springer Vienna,Springer Nature B.V
• Subject: Adult / Aphasia / Brain cancer / Brain Neoplasms - physiopathology / Brain Neoplasms - surgery / Case Report / Correspondence / Electrodes / Evoked Potentials - physiology / Female / General anesthesia / Glioma / Glioma - physiopathology / Glioma - surgery / Humans / Interventional Radiology / Intraoperative Neurophysiological Monitoring - methods / Language / Linguistics / Medicine / Medicine & Public Health / Minimally Invasive Surgery / Neurology / Neuronavigation - methods / Neuroradiology / Neurosurgery / Patients / Semantics / Statistical analysis / Surgery / Surgical Orthopedics / Transcranial Magnetic Stimulation - methods