SOURCE: Annals of Clinical & Translational Neurology. 9(9):1459-1464, 2022 Sep.

AUTHORS: Pasichnik A; Tsuboyama M; Jannati A; Vega C; Kaye HL; Damar U; Bolton J; Stone SSD; Madsen JR; Suarez RO; Rotenberg A

ABSTRACT: Neuronavigated transcranial magnetic stimulation (nTMS) has emerged as a presurgical language mapping tool distinct from the widely used functional magnetic resonance imaging (fMRI). We report fMRI and nTMS language-mapping results in 19 pediatric-epilepsy patients and compare those to definitive testing by electrical cortical stimulation, Wada test, and/or neuropsychological testing. Most discordant results occurred when fMRI found right-hemispheric language. In those cases, when nTMS showed left-hemispheric or bilateral language representation, left-hemispheric language was confirmed by definitive testing. Therefore, we propose nTMS should be considered for pediatric presurgical language-mapping when fMRI shows right-hemispheric language, with nTMS results superseding fMRI results in those scenarios.