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Improved pre-surgical causal language mapping combining 3T and 7T fMRI with TMS and E-field modelling in a young tumour patient

Anna-Lisa Schuler¹, Georg Widhalm¹, Michael Woletz¹, Martin Tik¹, Roland Fischer¹, Karl Rössler¹, and Christian Windischberger¹
¹Medical University of Vienna, Vienna, Austria

Using a multi-modal approach including language fMRI (3 and 7 Tesla), navigated repetitive TMS, a newly developed software for well-defined targeting and stimulus timings and combined E-field modelling/behavioural analysis we obtained strongly localised pre-surgical language mapping.

Figure 2. Stimulation targets and effective E-field. Depicted on the left side is the stimulation grid above the tumour. On the right side the E-field difference map (V/m) for “sure impairment” > “sure none-impairment” ratings is shown.

Figure 3. Comparison between 3 Tesla, 7 Tesla and E-field causal differentiation. The comparison between correlational and causal methods is strongly converging towards a functional hot spot inferior to the tumour in the anterior perisylvian region.