Tolerability of transcranial magnetic stimulation language mapping in children

Greiner, H. M.; Maue, E.; Horn, P. S.; Vannest, J.; Vedala, K.; Leach, J. L.; Tenney, J. R.; Williamson, B.; Fujiwara, H.; Coghill, R. C.; Mangano, F. T.; Kadis, D. S.

Abstract:

Objective: Transcranial Magnetic Stimulation (TMS) has emerged as a viable non-invasive method for mapping language networks. Little is known about the tolerability of transcranial magnetic stimulation language mapping in children. Methods: Children aged 5–18 years underwent bilateral language mapping using repetitive transcranial magnetic stimulation (rTMS) to target 33 sites/hemisphere. Stimulation was delivered at 5 Hz, in 1–2 second bursts, during visual naming and auditory verb generation. Pain unpleasantness and pain intensity were assessed using an unpleasantness visual analog scale (VAS). Results: 49 participants tolerated motor mapping and had repetitive transcranial magnetic stimulation. 35/49 (71%) completed visual naming and 26/49 (53%) completed both visual naming and verb generation. Mean electrical field per participant was 115 V/m. Young age and lower language ability were associated with lower completion. Visual analogue scale scores were significantly higher (6.1 vs. 2.8) in participants who withdrew early compared to those who completed at least visual naming. Conclusions: Pain measured by VAS was a major contributor to early withdrawal. However, a complete bilateral map was obtained with one paradigm in 71% of participants. Future studies designed to reduce pain during repetitive transcranial magnetic stimulation over language cortex will boost viability. Significance: This study represents the first attempt to characterize tolerability of bilateral repetitive transcranial magnetic stimulation language mapping in healthy children.

Patologie/Applicazioni:

• Stimolazione Magnetica Transcranica (TMS)
• Mapping
• Neurostimolazione nei bambini e adolescenti

Anno:

2023

Tipo di pubblicazione:

Articolo

Parola chiave:

TMS; rTMS; mapping; children; stimulation; neurostimulation; repetitive transcranial magnetic stimulation

Testata scientifica:

Epilepsy Research

Volume:

194

Mese:

08

Nota:

Questo è il primo studio sulla tollerabilità durante la mappatura del linguaggio in soggetti di giovane età. Il campione di riferimento è caratterizzato da 52 soggetti sani tra i 5 e 18 anni. Per quantificare il dolore che i soggetti dello studio hanno provato durante la mappatura è stata utilizzata la scala VAS, la quale ha dimostrato una buona tollerabilità della rTMS anche dei pazienti più giovani. I soggetti che hanno espresso un valore più alto nella scala VAS sono gli stessi che hanno abbandonato precocemente la seduta di trattamento. Si specifica che tale trattamente è stato somministrato con medesime procedure e uguali metodi.

DOI:

10.1016/j.eplepsyres.2023.107183