Neuromuscular DiseasesNeuromuscular DiseasesНервно-мышечные болезни2222-87212413-0443Publishing House ABV Press50410.17650/2222-8721-2022-12-4-10-19LECTURES AND REVIEWSЛЕКЦИИ И ОБЗОРЫTMS motor mapping: method overview, research and clinical applicationТМС-картирование моторной коры: обзор метода, исследовательское и клиническое значениеhttps://orcid.org/0000-0003-1841-1177PoydashevaA. G.ПойдашеваА. Г.
Russian Federation

Alexandra Georgievna Poydasheva 

80 Volokolamskoe Shosse, Moscow 125367

Александра Георгиевна Пойдашева  

125367 Москва, Волоколамское шоссе, 80

poydasheva@neurology.ruhttps://orcid.org/0000-0003-0716-3737BakulinI. S.БакулинИ. С.
Russian Federation

80 Volokolamskoe Shosse, Moscow 125367

125367 Москва, Волоколамское шоссе, 80

https://orcid.org/0000-0002-9267-8315LagodaD. Yu.ЛагодаД. Ю.
Russian Federation

80 Volokolamskoe Shosse, Moscow 125367

125367 Москва, Волоколамское шоссе, 80

https://orcid.org/0000-0003-3956-6362SuponevaN. A.СупоневаН. А.
Russian Federation

80 Volokolamskoe Shosse, Moscow 125367

125367 Москва, Волоколамское шоссе, 80

https://orcid.org/0000-0002-6338-0392PiradovM. A.ПирадовМ. А.
Russian Federation

80 Volokolamskoe Shosse, Moscow 125367

125367 Москва, Волоколамское шоссе, 80

Research Center of NeurologyФГБНУ «Научный центр неврологии»1312202212410191312202213122022Copyright ©; 2022, Poydasheva A.G., Bakulin I.S., Lagoda D.Y., Suponeva N.A., Piradov M.A.Copyright ©; 2022, Пойдашева А.Г., Бакулин И.С., Лагода Д.Ю., Супонева Н.А., Пирадов М.А.2022Poydasheva A.G., Bakulin I.S., Lagoda D.Y., Suponeva N.A., Piradov M.A.Пойдашева А.Г., Бакулин И.С., Лагода Д.Ю., Супонева Н.А., Пирадов М.А.https://creativecommons.org/licenses/by/4.0https://nmb.abvpress.ru/jour/article/view/504

Cortical representations of muscles can be probed non‑invasively using transcranial magnetic stimulation (TMS) motor mapping. TMS mapping can be applied both in research and clinical settings to assess motor cortex reorganization under the influence of various factors, to clarify pathophysiological mechanisms of motor system damage in various diseases, and to develop novel biomarkers of this damage. The article discusses the main methodological aspects of TMS motor mapping: choosing stimulation intensity and interstimulus interval, using of grid, neuronavigation and robotic systems, determining of a target muscle, etc. Special attention is paid to the cortical motor representation parameters such as the “hot spot” and center of gravity localization, area, etc. and their reproducibility under various mapping protocols. A review of publications on the use of TMS motor mapping application in brain tumors, stroke and amyotrophic lateral sclerosis is presented. The most significant practical impact of TMS motor mapping of the cortex is seen in brain tumors when used for presurgical localization of eloquent motor areas, as it is associated with the improvement of functional outcomes and progression‑free survival.

Транскраниальная магнитная стимуляция (ТМС) позволяет неинвазивно проводить картирование моторной коры и получать корковые представительства мышц. ТМС‑картирование нашло применение в исследовательской и клинической практике для оценки реорганизации моторной коры под действием различных факторов, уточнения патофизиологии и разработки новых биомаркеров поражения двигательной системы при различных заболеваниях. В статье обсуждаются основные методологические аспекты проведения ТМС‑картирования моторной коры: выбор интенсивности стимуляции и межстимульного интервала, использование сеточных алгоритмов, навигационных и роботизированных систем, выбор мышцы‑мишени и др. Отдельное внимание уделяется параметрам, характеризующим корковые представительства (локализация «горячей точки», центра масс, площадь и др.), и их воспроизводимости при использовании различных протоколов картирования. Приведен анализ публикаций, посвященных применению ТМС‑картирования моторной коры при опухолях, инсульте, боковом амиотрофическом склерозе. Наиболее значимое практическое применение ТМС‑картирование моторной коры получило при опухолях для предоперационного определения локализации функционально значимых моторных зон. Применение этого метода позволяет улучшить функциональные исходы операции и увеличить выживаемость пациентов без прогрессирования опухолевого процесса.

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