TMS Motor Mapping Applications
Basic Neurophysiology / Plasticity Assessment
Mapping the motor cortex with TMS enables assessing motor cortex physiology and plasticity. For instance,
corticomotor representation of finger muscles can be mapped using single pulse TMS. These muscle-specific maps
are thought to contain spatial information about its functional cortical representation in motor cortex and is used to
study plasticity of human hand. Additional examples include studying relationship of direction of TMS induced
current to cortical output, neuronal reactivity, cortical connectivity, obtain insights into mechanisms for diseases
involving motor problems, etc.
Brain Surgery Planning
The determination of viable cortical areas responsible for function is crucial for safe and effective resection. The
need to resect as much as possible is continuously balanced by the need to preserve the patient’s existing function
and quality of life. In addition, the tumor itself may distort underlying anatomical features. As navigated TMS allows
co-registration of motor maps with the patient’s anatomical scan, localization of the exact area for a response can
be readily determined. Infact, navigated TMS has been validated to be as accurate to Direct Cortical Stimulation
which is considered the gold standard for generating maps of the motor system.
Motor recovery after stroke
TMS Motor Mapping may act as a marker for recovery of function after stroke. It is known that clinical
improvement of hand function after stroke is accompanied by profound functional reorganization within motor
areas of both hemispheres, representing brain plasticity changes. These could be either beneficial or detrimental
and as such can be mapped using TMS. For instance, measuring the location, extent, and amount of cortical hand
motor representation, within motor cortices of both the lesioned and the non-lesioned hemisphere help
understand the mechanisms underlying motor recovery after stroke. Similarly, studying the aforementioned metrics
over time also contribute to this understanding. The knowledge of the underlying changes within motor cortex
after stroke may help develop individualized treatment approaches aiming to modulate maladaptive plasticity in
order to facilitate recovery after stroke.
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