Language mapping in healthy volunteers and brain tumor patients with a novel navigated TMS system: evidence of tumor-induced plasticity

Clin Neurophysiol. 2014 Mar;125(3):526-36. doi: 10.1016/j.clinph.2013.08.015. Epub 2013 Sep 16.


Objective: This article explores the feasibility of a novel repetitive navigated transcranial magnetic stimulation (rnTMS) system and compares language mapping results obtained by rnTMS in healthy volunteers and brain tumor patients.

Methods: Fifteen right-handed healthy volunteers and 50 right-handed consecutive patients with left-sided gliomas were examined with a picture-naming task combined with time-locked rnTMS (5-10 Hz and 80-120% resting motor threshold) applied over both hemispheres. Induced errors were classified into four psycholinguistic types and assigned to their respective cortical areas according to the coil position during stimulation.

Results: In healthy volunteers, language disturbances were almost exclusively induced in the left hemisphere. In patients errors were more frequent and induced at a comparative rate over both hemispheres. Predominantly dysarthric errors were induced in volunteers, whereas semantic errors were most frequent in the patient group.

Conclusion: The right hemisphere's increased sensitivity to rnTMS suggests reorganization in language representation in brain tumor patients.

Significance: rnTMS is a novel technology for exploring cortical language representation. This study proves the feasibility and safety of rnTMS in patients with brain tumor.

Keywords: Brain tumors; Hemispheric dominance; Language mapping; Language plasticity; Transcranial magnetic stimulation.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Brain / physiology*
  • Brain Mapping / methods*
  • Brain Neoplasms / pathology*
  • Brain Neoplasms / physiopathology*
  • Brain Neoplasms / surgery
  • Craniotomy
  • Female
  • Healthy Volunteers
  • Humans
  • Language Tests
  • Language*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neuronal Plasticity*
  • Preoperative Period
  • Psycholinguistics
  • Semantics
  • Transcranial Magnetic Stimulation / methods*