Intraoperative integration of nTMS, CCEPs and DCS for language. A glance to the next future?
Camilla Bonaudo, Riccardo Carrai, Edoardo Pieropan, Francesca Fedi, Eleonora Visocchi, Fabrizio Baldanzi, Francesca Battista, Antonello Grippo, Alessandro Della Puppa
Abstract
Open AccessBACKGROUND: 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.