In patients with low-grade gliomas, it is not always possible to achieve gross total resection, as some of the tumor can have function. Knowing they still have tumor in the brain, patients are understandably keen to know how if a reoperation is possible and how long they need to wait. Dr. Berger says that in his experience, function moves out of the tumor into the surrounding tissues 40% of the time—allowing for successful reoperation. But, he adds, this is very difficult to predict and ascertain from just MRI scans. Here, Dr. Berger believes nTMS can be real game-changer in neurosurgery because, for the first time, neurosurgeons can now study the migration of muscle groups non-invasively and in real-time—and identify the optimal timing for repeat resection.
“Overall, I am very impressed with nTMS and I am not an easy person to be convinced,” says Dr. Berger. He concluded his talk by stating, “If we can utilize this information from nTMS to help us understand about plasticity, the change in location of function, then that’s going to be magnificent!”
In his introduction Dr. Berger reminded the audience on his objectivity as a symposium speaker – he is not a paid consultant to Nexstim Plc. and receives no financial benefit from his participation in the DGNC lunch symposium.